Abstract
Background
There are many indications for hepatic retransplantation.
Aim
To identify factors influencing retransplantation needs and outcomes.
Patients and methods
Retransplantation records from January 1993 to March 2005 were analysed. Patient and disease characteristics and survival outcomes for retransplantation were compared between various groups.
Results
Totally, 286 primary and 42 hepatic retransplantations were performed. Retransplantation indications included primary sclerosing cholangitis (PSC), primary biliary cirrhosis, chronic hepatitis C (HCV), chronic active hepatitis (CAH), and alcohol-related disease. Mean follow-up post-retransplantation was 31 ± 9 months. Actuarial patient survival at 3 months, 1 year, 3 years, 5 years, and at the end of study was 71.4, 69, 59.5, 54.7, and 50%, respectively. Early and late retransplantation had 1-year survival of 73 and 68.5%, respectively. Retransplantation need was significantly higher for PSC, HCV, and CAH.
Conclusions
Hepatic retransplantation remains a successful salvage option for transplant complications; however, its need is significantly influenced by the primary liver disease.
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References
Busuttil RW, Farmer DG, Yersiz H et al (2005) Analysis of long-term outcomes of 3200 liver transplantations over two decades: a single-center experience. Ann Surg 241:905–916. doi:10.1097/01.sla.0000164077.77912.98
Azoulay D, Pfitzmann R, Benscheidt B et al (2007) Trends and experience in liver transplantation over 15 years. Liver Transpl 13:248–257. doi:10.1002/lt.20904
Markmann FJ, Markowitz SJ, Yersiz H et al (1997) Long-term survival after retransplantation of the liver. Ann Surg 226:408–420. doi:10.1097/00000658-199710000-00002
Yoo HY, Maheshwari A, Thuluvath PJ (2003) Retransplantation of liver: primary graft nonfunction and hepatitis C virus are associated with worse outcome. Liver Transpl 9:897–904. doi:10.1053/jlts.2003.50176
D’Alessandro AM, Ploeg RJ, Knechtle SJ et al (1993) Retransplantation of the liver—a seven year experience. Transplantation 55:1083–1087
Saito S, Langnas AN, Stratta RJ et al (1992) Hepatic retransplantation: University of Nebraska Medical Center experience. Clin Transpl 46:430–435
Seaberg EC, Belle SH, Beringer KC et al (1997) Long-term patient and retransplantation-free survival by selected recipient and donor characteristics: an update from the Pitt-UNOS Liver Transplant Registry. Clin Transpl:15–28
Postma R, Haagsma EB, Peeters PM et al (2004) Retransplantation of the liver in adults: outcome and predictive factors for survival. Transpl Int 17:234–240. doi:10.1111/j.1432-2277.2004.tb00436.x
Facciuto M, Heidt D, Guarrera J et al (2000) Retransplantation for late liver graft failure: predictors of mortality. Liver Transpl 6:174–179
Azoulay D, Linhares MM, Huguet E et al (2002) Decision for retransplantation of the liver: an experience- and cost-based analysis. Ann Surg 236:713–721. doi:10.1097/00000658-200212000-00003
Landaverde C, Berenguer M, Aguilera V et al (2005) Liver retransplantation: outcome analysis in 50 patients. Med Clin (Barc) 124:721–725. doi:10.1157/13075442
Bilbao I, Figueras J, Grande L et al (2003) Risk factors for death following liver retransplantation. Transplant Proc 35:1871–1873. doi:10.1016/S0041-1345(03)00585-2
Rosen HR, Madden JP, Martin P (1999) A model to predict survival following liver retransplantation. Hepatology 29:365–370. doi:10.1002/hep.510290221
Neff GW, O’Brien CB, Nery J et al (2004) Factors that identify survival after liver retransplantaion for allograft failure caused by recurrent hepatitis C infection. Liver Transpl 10:1504–1506. doi:10.1002/lt.20325
Ghobrial RM, Farmer DG, Baquerizo A et al (1999) Orthotopic liver trasnplantation for hepatitis C: outcome, effect of immunosuppression, and causes of retransplantation during 8-year single-center experience. Ann Surg 229:824–831. doi:10.1097/00000658-199906000-00009
Kim WR, Wiesner RH, Poterucha JJ et al (1999) Hepatic retransplantation in cholestatic liver disease: impact of the interval to retransplantation on survival and resources utilization. Hepatology 30:395–400. doi:10.1002/hep.510300210
Maheshwari A, Yoo HY, Thuluvath PJ (2004) Long-term outcome of liver transplantation in patients with PSC comparative analysis with PBC. Am J Gastroenterol 99:538–542. doi:10.1111/j.1572-0241.2004.04050.x
Roayaie S, Schiano TD, Thung SN et al (2003) Results of retransplantation for recurrent hepatitis C. Hepatology 38:1428–1436
McCashland T, Watt K, Lyden E, Adams L, Charlton M, Smith AD et al (2007) Retransplantation for hepatitis C: results of a U.S. multicenter retransplant study. Liver Transpl 13:1246–1253. doi:10.1002/lt.21322
Qasim A, McCormick A, Tajjudin T et al (2007) Improved survival outcomes for orthotopic liver transplantation. Ir Med J 100(3):389–390
Yan JQ, Peng CH, Li HW et al (2007) Preliminary clinical experience in liver retransplantation. Hepatobiliary Pancreat Dis Int 6:152–156
Magee JC, Barr ML, Basadonna GP et al (2007) Repeat organ transplantation in the United States, 1996–2005. Am J Transplant 7:1424–1433. doi:10.1111/j.1600-6143.2007.01786.x
Busuttil RW, Colonna JO, Hiatt JR et al (1987) The first 100 liver transplants at UCLA. Ann Surg 206:387–402. doi:10.1097/00000658-198710000-00001
Launois B, Meunier B, Foglia M et al (1996) 200 first hepatic transplantation at the Rennes University Hospital (in French). Chirurgie 121:207–214
Acknowledgments
The authors wish to express their gratitude to all of our transplant coordinators, nursing staff, and administrative personnel, without whom this work would not have been possible.
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Qasim, A., Zaman, B.M., Geoghegan, J. et al. Significant influence of the primary liver disease on the outcomes of hepatic retransplantation. Ir J Med Sci 178, 47–51 (2009). https://doi.org/10.1007/s11845-008-0234-z
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DOI: https://doi.org/10.1007/s11845-008-0234-z