In:
Clinical Transplantation, Wiley, Vol. 20, No. s16 ( 2006-10), p. 29-29
Abstract:
Background: Survival after retransplants (ReLTs) is inferior to that after primary liver transplantation. Adult‐to‐adult living donor liver transplants (AALDLTs) are an emerging method to treat patients with end‐stage liver disease. The aim of this study is to analyze outcomes of ReLTs as compared with those achieved with deceased donors (ReDDLTs) and living liver donors (ReLDLTs), by determining variables affecting allograft and patient survival. Methods: From January 2000 through November 2005, 23 (8%) of 288 LTs were late ReLTs ( 〉 6 months). Recipients were divided into 2 groups: ReDDLTs (n=14) and ReLDLTs (n=9). The overall M/F ratio was 16/7 (mean age, 49 years). Secondary biliary cirrhosis and HCV recurrence were the main indications for ReLTs. Results: Both groups were comparable for MELD and Child status (CTP) at the time of their ReLTs, with the exception of higher median serum creatinine levels in the ReDDLT group. Waiting list time from decision to retransplant was 48±80 days in the ReLDLT group and 199±207 days in the ReDDLT group (p=0.006). Living donor morbidity consisted of 1 biliary leak and 1 incisional hernia. According to univariate analysis, recipient BMI, vascular thrombosis at ReLT, and creatinine levels were independent predictors of graft survival, whereas CTP score ≥ 10 was the only predictor of mortality after late ReLT. Our 1‐ and 3‐year patient survival rates in ReDDLT vs. ReLDLT recipients were 79% and 79% vs. 89% and 89% (p = 0.33); our 1‐ and 3‐year graft survival rates were 79% and 79% vs. 67% and 67% (p=0.25). Conclusions: Our results suggest that the severity of graft failure based on CTP increases the risk of death after ReLTs, whereas renal insufficiency and previous vascular thrombosis are predisposing factors for early graft loss. Late ReLTs with a living donor graft allow ReLTs to take place in due time, with acceptable donor morbidity and without hampering the deceased donor liver pool. However, better patient selection is warranted.
Type of Medium:
Online Resource
ISSN:
0902-0063
,
1399-0012
DOI:
10.1111/ctr.2006.20.issue-s16
DOI:
10.1111/j.1399-0012.2006.00577_3_6.x
Language:
English
Publisher:
Wiley
Publication Date:
2006
detail.hit.zdb_id:
2739458-X
detail.hit.zdb_id:
2004801-4
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