Since the early eighties, liver transplantation has quickly become the ultimate solution for patients with end-stage liver disease. As a result, liver transplant programs proliferated all over the world, particularly in North America and Europe. This has not been the case in the developing countries, due to the lack of qualified technical experience with the procedure, the lack of advanced hospital set-ups required to support such a demanding procedure, and finally the cost. This led to the establishment of only a few centers, in addition to a few sporadic cases being performed outside a well-organized program.
Liver disease is endemic in Saudi Arabia.
It is estimated that at least 300-500 patients require liver transplantation annually. Between 30 and 50 Saudi patients a year receive transplants in the USA, at a total cost of approximately 50 million US dollars. This, among other factors, has led to the establishment of liver transplant programs in the Kingdom. In this paper, we describe our experience with the establishment of this program, emphasizing problems peculiar to developing countries. The largest transplant center was launched in 1994 at King Fahad National Guard Hospital.