BACKGROUND: Transplantation of more than two livers for recurring graft failure has not been specifically addressed in the literature. METHODS: A retrospective analysis was conducted from a total of 2527 overall liver transplants at our institution. Main indications for multiple retransplant included primary nonfunction, chronic rejection, hepatic artery thrombosis, and recurrent disease. RESULTS: We identified 39 patients who received more than two grafts (32 received 3 grafts, 5 received 4 grafts, and 2 received 5 grafts). All patients required interposition arterial grafts from the aorta and hepatojejunostomy for the biliary reconstruction. Seventeen patients are still alive at last follow-up. Perioperative mortality rates after 3rd, 4th, and 5th liver graft were 25%, 14%, and 50%, respectively. Patient and graft survival rates were 72% and 56% at 1 year, respectively. Median length of stay was 27 days and median graft survival was 2.9 years. CONCLUSIONS: Selection of patients and a significant use of available resources are some of the important factors that clinicians need to take into account when dealing with multiple retransplantations. With such conditions, however, liver retransplantation of more than two grafts can be a life-saving procedure.
BACKGROUND: Transplantation of more than two livers for recurring graft failure has not been specifically addressed in the literature. METHODS: A retrospective analysis was conducted from a total of 2527 overall liver transplants at our institution. Main indications for multiple retransplant included primary nonfunction, chronic rejection, hepatic artery thrombosis, and recurrent disease. RESULTS: We identified 39 patients who received more than two grafts (32 received 3 grafts, 5 received 4 grafts, and 2 received 5 grafts). All patients required interposition arterial grafts from the aorta and hepatojejunostomy for the biliary reconstruction. Seventeen patients are still alive at last follow-up. Perioperative mortality rates after 3rd, 4th, and 5th liver graft were 25%, 14%, and 50%, respectively. Patient and graft survival rates were 72% and 56% at 1 year, respectively. Median length of stay was 27 days and median graft survival was 2.9 years. CONCLUSIONS: Selection of patients and a significant use of available resources are some of the important factors that clinicians need to take into account when dealing with multiple retransplantations. With such conditions, however, liver retransplantation of more than two grafts can be a life-saving procedure.
Authors: Roberta Angelico; Bruno Sensi; Tommaso M Manzia; Giuseppe Tisone; Giuseppe Grassi; Alessandro Signorello; Martina Milana; Ilaria Lenci; Leonardo Baiocchi Journal: World J Gastroenterol Date: 2021-12-07 Impact factor: 5.742
Authors: Peter D Yoon; Madhukar S Patel; Carla F Murillo Perez; Tommy Ivanics; Marco P A W Claasen; Hala Muaddi; David Wallace; Bettina Hansen; Gonzalo Sapisochin Journal: Can J Gastroenterol Hepatol Date: 2022-03-22
Authors: Seung-Young Oh; Eun Jin Jang; Ga Hee Kim; Hannah Lee; Nam-Joon Yi; Seokha Yoo; Bo Rim Kim; Ho Geol Ryu Journal: PLoS One Date: 2021-08-05 Impact factor: 3.240