Liver retransplantation: A single-centre experience

Yi Ma, Guo Dong Wang, Xiao Shun He, Jun Liang Li

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Background: The curative effect of liver transplantation for patients with end-stage liver disease was encouraging in recent years and the 5-year patient survival rate can reach up to 70%. However, some patients might lose grafts due to a variety of reasons, including bile duct complications, vascular complications, primary non-function, graft rejection and disease recurrence etc. Liver retransplantation (re-LT) was the only available means for those patients whose initial grafts had failed, but the inferior outcomes of re-LT compared to primary liver transplantation (PLT) continue to be a major concern. This study aimed to analyze the indications for re-LT, optimal timing of re-LT, and strategies to improve the survival rate after re-LT. Methods: From January 2001 to December 2006, we performed 738 liver transplants and 39 re-LT (5.3%) at our center. A retrospective analysis was performed to identify factors (indication for re-LT, preoperative score of model for end-stage liver disease (MELD), interval to re-LT from primary liver transplantation, methods of vascular and biliary reconstruction and common causes of death) associated with survival. Results: Mean follow-up period was 1.8 years (1 to 5 years). Patients with MELD score less than 20 were better than those whose MELD score was >20 and MELD score>30 (1-year survival, 80.0% versus 50.0% and 3/ 5). The perioperative survival rate of patients who received re-LT at an interval of more than 30 days and less than 8 days after the initial transplantation was higher than those who received retransplantation between 8 to 30 days following the first operation (88.5% and 74.3% versus 50.0%). The main causes of death were infection (60.0%), multiple organ failure (20.0%), vascular complications (10.0%) and biliary fistula (10.0%) in perioperative period. The overall patient survival rate of 1-month, 6-month and 1-year was 80.0%, 76.7% and 66.7%, respectively. Conclusions: Our study suggested the favorable results after re-LT. The analysis also showed optimal timing of operation, refined surgical techniques, individualized immunosuppressive regimen and effective prophylaxis and treatment of perioperative infection play an important role in achieving a higher survival after re-LT.

Original languageEnglish (US)
Pages (from-to)1987-1991
Number of pages5
JournalChinese Medical Journal
Volume121
Issue number20
DOIs
StatePublished - Oct 20 2008

Keywords

  • Complications
  • Infection
  • Liver retransplantation
  • Model for end-stage liver disease score

ASJC Scopus subject areas

  • Medicine(all)

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