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Abaalkhail FA, Al Sebayel MI, Shagrani MA, O’Hali WA, Almasri NM, Alalwan AA, Alghamdi MY, Al-Bahili H, AlQahtani MS, Alabbad SI, Al-Hamoudi WK, Alqahtani SA. Clinical Practice Guidelines for Liver Transplantation in Saudi Arabia. Saudi Med J 2021; 42:927-968. [PMID: 34470833 PMCID: PMC9280503 DOI: 10.15537/smj.2021.42.9.20210126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/22/2021] [Indexed: 11/26/2022] Open
Abstract
The demand for liver transplantation in the Kingdom of Saudi Arabia (KSA) is associated with the country’s high burden of liver disease. Trends in the epidemiology of liver transplantation indications among recipients in KSA have changed over 20 years. Non-alcoholic steatohepatitis has eclipsed the hepatitis C virus in the country due to the effective treatment strategies for HCV. Risk factors for NASH, like type 2 diabetes mellitus, obesity, and hyperlipidemia, are becoming a major concern and a leading indication for liver transplantation in the KSA. There is also a significantly increased prevalence and incidence of genetic adult familial liver diseases in KSA. New immunosuppressive agents and preservation solutions, improved surgical capabilities, and early disease recognition and management have increased the success rate of liver transplant outcome but concerns about the side effects of immunosuppressive therapy can jeopardise long-term survival outcomes. Despite this, indications for liver transplantation continue to increase, resulting in ongoing challenges to maximize the number of potential donors and reduce patient mortality rate while expecting to get transplanted. The Saudi Center of Organ Transplant is the recognized National Organ Donation Agency for transplantation, which renders important support for procurement and allocation of organs. This guidance document aims to help healthcare providers in managing patients in the liver transplant setting.
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Affiliation(s)
- Faisal A. Abaalkhail
- From the Department of Medicine (Abaalkhail), Gastroenterology Section, from the Organ Transplant Center (Shagrani, Alabbad, Al-hamoudi, Alqahtani S), King Faisal Specialist Hospital & Research Center; from the College of Medicine (Abaalkhail, Shagrani,) Alfaisal University; from the Department of Surgery (Al Sebayel), Almaarefah University; from the Hepatobiliary Sciences and Organ Transplant Center (O’Hali, Alalwan), King Abdulaziz Medical City; from the Department of Medicine (Almasri), Multiorgan Transplant Center (Al-Bahili), Prince Sultan Medical Military City; from the Liver Research Center (Al-hamoudi), King Saud University, Riyadh; from the Department of Medicine (Alghamdi), King Fahd Military Medical Complex, Dahran; from the Multi-Organ Transplant Center (Alqahtani M), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia; and from the Johns Hopkins University (Alqahtani S), Baltimore, MD, United States of America.
- Address correspondence and reprint request to: Dr. Faisal A. Abaalkhail, Department of Medicine, Gastroenterology Section, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia. E-mail: ORCID ID: http://orcid.org/0000-0003-1287-9887
| | - Mohammed I. Al Sebayel
- From the Department of Medicine (Abaalkhail), Gastroenterology Section, from the Organ Transplant Center (Shagrani, Alabbad, Al-hamoudi, Alqahtani S), King Faisal Specialist Hospital & Research Center; from the College of Medicine (Abaalkhail, Shagrani,) Alfaisal University; from the Department of Surgery (Al Sebayel), Almaarefah University; from the Hepatobiliary Sciences and Organ Transplant Center (O’Hali, Alalwan), King Abdulaziz Medical City; from the Department of Medicine (Almasri), Multiorgan Transplant Center (Al-Bahili), Prince Sultan Medical Military City; from the Liver Research Center (Al-hamoudi), King Saud University, Riyadh; from the Department of Medicine (Alghamdi), King Fahd Military Medical Complex, Dahran; from the Multi-Organ Transplant Center (Alqahtani M), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia; and from the Johns Hopkins University (Alqahtani S), Baltimore, MD, United States of America.
| | - Mohammed A. Shagrani
- From the Department of Medicine (Abaalkhail), Gastroenterology Section, from the Organ Transplant Center (Shagrani, Alabbad, Al-hamoudi, Alqahtani S), King Faisal Specialist Hospital & Research Center; from the College of Medicine (Abaalkhail, Shagrani,) Alfaisal University; from the Department of Surgery (Al Sebayel), Almaarefah University; from the Hepatobiliary Sciences and Organ Transplant Center (O’Hali, Alalwan), King Abdulaziz Medical City; from the Department of Medicine (Almasri), Multiorgan Transplant Center (Al-Bahili), Prince Sultan Medical Military City; from the Liver Research Center (Al-hamoudi), King Saud University, Riyadh; from the Department of Medicine (Alghamdi), King Fahd Military Medical Complex, Dahran; from the Multi-Organ Transplant Center (Alqahtani M), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia; and from the Johns Hopkins University (Alqahtani S), Baltimore, MD, United States of America.
| | - Wael A. O’Hali
- From the Department of Medicine (Abaalkhail), Gastroenterology Section, from the Organ Transplant Center (Shagrani, Alabbad, Al-hamoudi, Alqahtani S), King Faisal Specialist Hospital & Research Center; from the College of Medicine (Abaalkhail, Shagrani,) Alfaisal University; from the Department of Surgery (Al Sebayel), Almaarefah University; from the Hepatobiliary Sciences and Organ Transplant Center (O’Hali, Alalwan), King Abdulaziz Medical City; from the Department of Medicine (Almasri), Multiorgan Transplant Center (Al-Bahili), Prince Sultan Medical Military City; from the Liver Research Center (Al-hamoudi), King Saud University, Riyadh; from the Department of Medicine (Alghamdi), King Fahd Military Medical Complex, Dahran; from the Multi-Organ Transplant Center (Alqahtani M), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia; and from the Johns Hopkins University (Alqahtani S), Baltimore, MD, United States of America.
| | - Nasser M. Almasri
- From the Department of Medicine (Abaalkhail), Gastroenterology Section, from the Organ Transplant Center (Shagrani, Alabbad, Al-hamoudi, Alqahtani S), King Faisal Specialist Hospital & Research Center; from the College of Medicine (Abaalkhail, Shagrani,) Alfaisal University; from the Department of Surgery (Al Sebayel), Almaarefah University; from the Hepatobiliary Sciences and Organ Transplant Center (O’Hali, Alalwan), King Abdulaziz Medical City; from the Department of Medicine (Almasri), Multiorgan Transplant Center (Al-Bahili), Prince Sultan Medical Military City; from the Liver Research Center (Al-hamoudi), King Saud University, Riyadh; from the Department of Medicine (Alghamdi), King Fahd Military Medical Complex, Dahran; from the Multi-Organ Transplant Center (Alqahtani M), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia; and from the Johns Hopkins University (Alqahtani S), Baltimore, MD, United States of America.
| | - Abduljaleel A. Alalwan
- From the Department of Medicine (Abaalkhail), Gastroenterology Section, from the Organ Transplant Center (Shagrani, Alabbad, Al-hamoudi, Alqahtani S), King Faisal Specialist Hospital & Research Center; from the College of Medicine (Abaalkhail, Shagrani,) Alfaisal University; from the Department of Surgery (Al Sebayel), Almaarefah University; from the Hepatobiliary Sciences and Organ Transplant Center (O’Hali, Alalwan), King Abdulaziz Medical City; from the Department of Medicine (Almasri), Multiorgan Transplant Center (Al-Bahili), Prince Sultan Medical Military City; from the Liver Research Center (Al-hamoudi), King Saud University, Riyadh; from the Department of Medicine (Alghamdi), King Fahd Military Medical Complex, Dahran; from the Multi-Organ Transplant Center (Alqahtani M), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia; and from the Johns Hopkins University (Alqahtani S), Baltimore, MD, United States of America.
| | - Mohammed Y. Alghamdi
- From the Department of Medicine (Abaalkhail), Gastroenterology Section, from the Organ Transplant Center (Shagrani, Alabbad, Al-hamoudi, Alqahtani S), King Faisal Specialist Hospital & Research Center; from the College of Medicine (Abaalkhail, Shagrani,) Alfaisal University; from the Department of Surgery (Al Sebayel), Almaarefah University; from the Hepatobiliary Sciences and Organ Transplant Center (O’Hali, Alalwan), King Abdulaziz Medical City; from the Department of Medicine (Almasri), Multiorgan Transplant Center (Al-Bahili), Prince Sultan Medical Military City; from the Liver Research Center (Al-hamoudi), King Saud University, Riyadh; from the Department of Medicine (Alghamdi), King Fahd Military Medical Complex, Dahran; from the Multi-Organ Transplant Center (Alqahtani M), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia; and from the Johns Hopkins University (Alqahtani S), Baltimore, MD, United States of America.
| | - Hamad Al-Bahili
- From the Department of Medicine (Abaalkhail), Gastroenterology Section, from the Organ Transplant Center (Shagrani, Alabbad, Al-hamoudi, Alqahtani S), King Faisal Specialist Hospital & Research Center; from the College of Medicine (Abaalkhail, Shagrani,) Alfaisal University; from the Department of Surgery (Al Sebayel), Almaarefah University; from the Hepatobiliary Sciences and Organ Transplant Center (O’Hali, Alalwan), King Abdulaziz Medical City; from the Department of Medicine (Almasri), Multiorgan Transplant Center (Al-Bahili), Prince Sultan Medical Military City; from the Liver Research Center (Al-hamoudi), King Saud University, Riyadh; from the Department of Medicine (Alghamdi), King Fahd Military Medical Complex, Dahran; from the Multi-Organ Transplant Center (Alqahtani M), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia; and from the Johns Hopkins University (Alqahtani S), Baltimore, MD, United States of America.
| | - Mohammed S. AlQahtani
- From the Department of Medicine (Abaalkhail), Gastroenterology Section, from the Organ Transplant Center (Shagrani, Alabbad, Al-hamoudi, Alqahtani S), King Faisal Specialist Hospital & Research Center; from the College of Medicine (Abaalkhail, Shagrani,) Alfaisal University; from the Department of Surgery (Al Sebayel), Almaarefah University; from the Hepatobiliary Sciences and Organ Transplant Center (O’Hali, Alalwan), King Abdulaziz Medical City; from the Department of Medicine (Almasri), Multiorgan Transplant Center (Al-Bahili), Prince Sultan Medical Military City; from the Liver Research Center (Al-hamoudi), King Saud University, Riyadh; from the Department of Medicine (Alghamdi), King Fahd Military Medical Complex, Dahran; from the Multi-Organ Transplant Center (Alqahtani M), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia; and from the Johns Hopkins University (Alqahtani S), Baltimore, MD, United States of America.
| | - Saleh I. Alabbad
- From the Department of Medicine (Abaalkhail), Gastroenterology Section, from the Organ Transplant Center (Shagrani, Alabbad, Al-hamoudi, Alqahtani S), King Faisal Specialist Hospital & Research Center; from the College of Medicine (Abaalkhail, Shagrani,) Alfaisal University; from the Department of Surgery (Al Sebayel), Almaarefah University; from the Hepatobiliary Sciences and Organ Transplant Center (O’Hali, Alalwan), King Abdulaziz Medical City; from the Department of Medicine (Almasri), Multiorgan Transplant Center (Al-Bahili), Prince Sultan Medical Military City; from the Liver Research Center (Al-hamoudi), King Saud University, Riyadh; from the Department of Medicine (Alghamdi), King Fahd Military Medical Complex, Dahran; from the Multi-Organ Transplant Center (Alqahtani M), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia; and from the Johns Hopkins University (Alqahtani S), Baltimore, MD, United States of America.
| | - Waleed K. Al-Hamoudi
- From the Department of Medicine (Abaalkhail), Gastroenterology Section, from the Organ Transplant Center (Shagrani, Alabbad, Al-hamoudi, Alqahtani S), King Faisal Specialist Hospital & Research Center; from the College of Medicine (Abaalkhail, Shagrani,) Alfaisal University; from the Department of Surgery (Al Sebayel), Almaarefah University; from the Hepatobiliary Sciences and Organ Transplant Center (O’Hali, Alalwan), King Abdulaziz Medical City; from the Department of Medicine (Almasri), Multiorgan Transplant Center (Al-Bahili), Prince Sultan Medical Military City; from the Liver Research Center (Al-hamoudi), King Saud University, Riyadh; from the Department of Medicine (Alghamdi), King Fahd Military Medical Complex, Dahran; from the Multi-Organ Transplant Center (Alqahtani M), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia; and from the Johns Hopkins University (Alqahtani S), Baltimore, MD, United States of America.
| | - Saleh A. Alqahtani
- From the Department of Medicine (Abaalkhail), Gastroenterology Section, from the Organ Transplant Center (Shagrani, Alabbad, Al-hamoudi, Alqahtani S), King Faisal Specialist Hospital & Research Center; from the College of Medicine (Abaalkhail, Shagrani,) Alfaisal University; from the Department of Surgery (Al Sebayel), Almaarefah University; from the Hepatobiliary Sciences and Organ Transplant Center (O’Hali, Alalwan), King Abdulaziz Medical City; from the Department of Medicine (Almasri), Multiorgan Transplant Center (Al-Bahili), Prince Sultan Medical Military City; from the Liver Research Center (Al-hamoudi), King Saud University, Riyadh; from the Department of Medicine (Alghamdi), King Fahd Military Medical Complex, Dahran; from the Multi-Organ Transplant Center (Alqahtani M), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia; and from the Johns Hopkins University (Alqahtani S), Baltimore, MD, United States of America.
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