Clinical Indications for Adult and Pediatric Liver Transplantation in Iraq

Liver transplantation has continued to be a life-saving procedure for patients with end-stage liver disease. This study aimed to describe the indications, demographics, and outcomes of liver transplantation in one of the major transplant facilities in Iraq. A retrospective cohort, multi-center design was used as the sample, comprising 55 liver transplant recipients. The medical records were used to extract demographic variables, primary indication, Model for End-stage Liver Disease (MELD) scores, graft type, donor relation, and clinical outcome, and subject them to descriptive statistical analysis. The mean age of the transplant group was 40.7 years, and it was mostly composed of males (65.5%). The most common indications were cryptogenic cirrhosis (30.9%), NAFLD (20.0%), and alcoholic liver disease (14.5%), which summed up to 65.4% of all cases. The mean MELD at transplantation was 16.7, and the mean MELD of patients with alcoholic liver disease was highest (19.1). The program involved the use of living donors only, and right-lobe grafts comprised 74.5% of all transplants. The total survival of patients was 81.8%. It is noteworthy that the mean MELD score was higher in non-survivors (19.0) than in survivors (16.2). Cryptogenic cirrhosis, NAFLD, and alcoholic liver disease were the leading causes of liver transplantation in this Iraqi cohort, indicating a significant presence of metabolic and lifestyle-related liver disease. The living-only model achieved good survival results. The prognostic value of MELD is suggested by the higher mean MELD score observed among non-survivors. Such observations justify the introduction of targeted public health programs and serve as a regional benchmark for transplant services.