Liver transplantationOutcomeShort- and Long-Term Overall Results of Liver Retransplantation: “Doce de Octubre” Hospital Experience
Section snippets
Patients and Methods
From January 1992 to December 2006, we performed 960 orthotopic liver transplantations (OLT), including 54 liver retransplantations (5.6%). We included all adult patients with a liver retransplantation, excluding children and retransplantations outside of these dates. The mean patient age was 48.7 ± 12.4 years with 70.4% men. The main etiology was hepatitis C virus (HCV) cirrhosis (27.8%) or alcoholic cirrhosis (22.2%).
This retrospective study analyzed the results using SPSS for Windows v 15.0.
Results
The mean time between the first and the second transplantation was 2593 ± 1382 days with a median of 74 days. In this study, 34.7% of the retransplantations were performed at 4–30 days after the first one with the other 34.7% within 1 year after; namely, 18.4% between 31 and 360 days and only 12.2% in the first 3 days. Also, 48.9% of the retransplantations were performed in urgent situations.
The main cause for retransplantation during the first month was primary nonfunction (n = 14) or vascular
Discussion
The incidence of retransplantation during the last 14 years in our Department was 5.6%, which differed from other reports in the literature showing 10%–20%.1, 2, 3, 4, 5, 6, 7 Like others, the main cause for retransplantation was primary nonfunction followed by chronic rejection, but we noted a lower rate of patients with vascular complications. In our experience the main surgical complications were bleeding and abdominal wall complications, differing from the publication of Tzakis et al,25
References (25)
- et al.
Evolution of liver transplantation in Europe: report of the European Liver Transplant Registry
Liver Transpl
(2003) - et al.
Análisis of 500 liver transplantation at Bellvitge Hospital, Spain
Med Clin (Barcelona)
(2000) - et al.
Emergency organ transplantation in Spain: liver emergency and outcomes
Transplant Proc
(2005) - et al.
Causes of retransplantation after primary liver transplantation in 4000 consecutive patients: 2 to 19 years follow up
Transplant Proc
(2001) - et al.
Indications for liver retransplantation: 1087 liver transplantation between 1986 and 1997
Transplant Proc
(2002) - et al.
Does hepatic retransplantation entail an increase in the number of early reoperations?A decade of experience
Transplant Proc
(2002) - et al.
Early mortality in liver retransplantation: a multivariate analysis of risk factors
Transplant Proc
(2002) - et al.
Long-term survival after retransplantation of the liver
Ann Surg
(1997) - et al.
Experience with hepatic retransplantation
Transpl Proc
(1986) - Registro Español de Trasplante Hepático: Available at:...
Retransplantation for the hepatic allograft failurePrognostic modelling and ethical considerations
Liver Transpl
Decision for retransplantation of the liver: an experience- and cost-based analysis
Ann Surg
Cited by (9)
Liver Retransplantation: How Much Is Too Much?
2017, Clinics in Liver DiseaseCitation Excerpt :Others have reported patients with varying percentages of retransplants who underwent subsequent multiple retransplants but have not indicated the outcomes. Rates vary from one report of 21.1% of 54 retransplants requiring a third graft36 to another with 774 retransplant patients with 148 undergoing a third (19%), 20 a fourth (2.5%), and 5 having more than 4 grafts (0.6%).9 Another study in Europe with 108 retransplants found 9 patients needing 3 grafts, and 1 patient needing a fourth,18 and the UNOS study by Yoo and colleagues22 from 1988 to 2001 showed 4189 retransplants, 10.6% of which required a third transplant.22
Ethical Decisions in Transplantation
2015, Transplantation of the Liver: Third EditionHepatic Retransplant. What Have We Learned?
2014, Clinics in Liver DiseaseCitation Excerpt :Consistent with the hypothesis that sicker patients fare worse after retransplant, patients requiring emergent liver retransplant (eg, UNOS Status 1) have also been claimed to have inferior outcomes according to some case series.7,10 However, other groups failed to demonstrate a difference in patient survival for urgent versus elective retransplant.17 Increasing recipient age is another variable linked to worse retransplant outcomes.15,49,80,88–90
Have we changed the liver retransplantation survival?
2012, Transplantation ProceedingsInfluence of selected factors on survival after liver retransplantation
2011, Transplantation ProceedingsCitation Excerpt :The incidence of retransplantation among 911 primary orthotopic liver grafts was 5.2%; it was among the lowest reported worldwide. The typical rate of liver retransplantation ranges between 10% and 20% of primary transplantations,4,5 but some centers report results similar to ours.6 There was a significant 22% difference in survival between primary OLT and re-OLT in favor of the primary procedure.
Three-times liver transplanted: How far shall we arrive?
2020, Medicina Intensiva