BACKGROUND: Retransplantation is the only form of treatment for patients with irreversible graft failure. The aim of this study was to analyse a single centre's experience of the indications for and outcomes of retransplantation. METHODS: A total of 196 patients who underwent liver retransplantation using 225 grafts, between January 1982 and July 2007, were included in the study. The following parameters were analysed: patient demographics; primary diagnosis; distribution of retransplantation over different time periods; indications for retransplantation; time interval to retransplantation, and overall patient and graft survival. RESULTS: Of the 2437 primary orthotopic liver transplantations, 196 patients (8%) required a first regraft, 23 patients (1%) a second regraft and six patients (0.25%) a third regraft. Autoimmune hepatitis was the most common primary diagnosis for which retransplantation was required (12.7% of primary transplantations). The retransplantation rate declined from 12% at the beginning of our programme to 7.6% at the end of the study period. The most common indication for retransplantation was hepatic artery thrombosis (31.6%). Nearly two-thirds of the retransplantations were performed within 6 months of the primary transplantation. The 1-, 3-, 5- and 10-year patient survival rates following first retransplantation were 66%, 61%, 57% and 47%, respectively. Five-year survival after second retransplantation was 40%. None of the patients have yet survived 3 years after a third regraft. Donor age of < or =55 years and a MELD (Model for End-stage Liver Disease) score of < or =23 were associated with better outcome following retransplantation. CONCLUSIONS: First retransplantation was associated with good longterm survival. There was no survival benefit following second and third retransplantations. A MELD score of < or =23 and donor age of < or =55 years correlated with better outcome following retransplantation.
BACKGROUND: Retransplantation is the only form of treatment for patients with irreversible graft failure. The aim of this study was to analyse a single centre's experience of the indications for and outcomes of retransplantation. METHODS: A total of 196 patients who underwent liver retransplantation using 225 grafts, between January 1982 and July 2007, were included in the study. The following parameters were analysed: patient demographics; primary diagnosis; distribution of retransplantation over different time periods; indications for retransplantation; time interval to retransplantation, and overall patient and graft survival. RESULTS: Of the 2437 primary orthotopic liver transplantations, 196 patients (8%) required a first regraft, 23 patients (1%) a second regraft and six patients (0.25%) a third regraft. Autoimmune hepatitis was the most common primary diagnosis for which retransplantation was required (12.7% of primary transplantations). The retransplantation rate declined from 12% at the beginning of our programme to 7.6% at the end of the study period. The most common indication for retransplantation was hepatic artery thrombosis (31.6%). Nearly two-thirds of the retransplantations were performed within 6 months of the primary transplantation. The 1-, 3-, 5- and 10-year patient survival rates following first retransplantation were 66%, 61%, 57% and 47%, respectively. Five-year survival after second retransplantation was 40%. None of the patients have yet survived 3 years after a third regraft. Donor age of < or =55 years and a MELD (Model for End-stage Liver Disease) score of < or =23 were associated with better outcome following retransplantation. CONCLUSIONS: First retransplantation was associated with good longterm survival. There was no survival benefit following second and third retransplantations. A MELD score of < or =23 and donor age of < or =55 years correlated with better outcome following retransplantation.
Authors: R Kashyap; A Jain; J Reyes; A J Demetris; K A Elmagd; S F Dodson; W Marsh; V Madariaga; G Mazariegos; D Geller; C A Bonham; T Cacciarelli; P Fontes; T E Starzl; J J Fung Journal: Transplant Proc Date: 2001 Feb-Mar Impact factor: 1.066
Authors: M Facciuto; D Heidt; J Guarrera; C A Bodian; C M Miller; S Emre; S R Guy; T M Fishbein; M E Schwartz; P A Sheiner Journal: Liver Transpl Date: 2000-03 Impact factor: 5.799
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Authors: Angus W Jeffrey; Luc Delriviere; Geoff McCaughan; Michael Crawford; Peter Angus; Robert Jones; Graeme A Macdonald; Jonathan Fawcett; Alan Wigg; John Chen; Ed Gane; Stephen Munn; Gary P Jeffrey Journal: Transplant Direct Date: 2019-07-23
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: Suzanne P Stam; Maryse C J Osté; Michele F Eisenga; Hans Blokzijl; Aad P van den Berg; Stephan J L Bakker; Vincent E de Meijer Journal: Am J Transplant Date: 2018-06-03 Impact factor: 8.086