BACKGROUND: The use of living donor liver transplantation (LDLT) for primary liver transplantation (LT) may quell concerns about allocating deceased donor organs if the need for retransplantation (re-LT) arises because the primary LT did not draw from the limited organ pool. However, outcomes of re-LT after LDLT are poorly studied. The purpose of this study was to analyze the Adult to Adult Living Donor Liver Transplantation Study (A2ALL) data to report outcomes of re-LT after LDLT, with a focus on long-term survival after re-LT. METHODS: A retrospective review of A2ALL data collected between 1998 and 2014 was performed. Patients were excluded if they received a deceased donor LT. Demographic data, postoperative outcomes and complications, graft and patient survival, and predictors of re-LT and patient survival were assessed. RESULTS: Of the 1065 patients who underwent LDLT during the study time period, 110 recipients (10.3%) required re-LT. In multivariable analyses, hepatitis C virus, longer length of stay at LDLT, hepatic artery thrombosis, biliary stricture, infection, and disease recurrence were associated with an increased risk of re-LT. Patient survival among re-LT patients was significantly inferior to those who underwent primary transplant only at 1 (86% versus 92%), 5 (64% versus 82%), and 10 years (44% versus 68%). CONCLUSIONS: Approximately 10% of A2ALL patients who underwent primary LDLT required re-LT. Compared with patients who underwent primary LT, survival among re-LT recipients was worse at 1, 5, and 10 years after LT, and re-LT was associated with a significantly increased risk of death in multivariable modeling (hazard ratios, 2.29; P < 0.001).
BACKGROUND: The use of living donor liver transplantation (LDLT) for primary liver transplantation (LT) may quell concerns about allocating deceased donor organs if the need for retransplantation (re-LT) arises because the primary LT did not draw from the limited organ pool. However, outcomes of re-LT after LDLT are poorly studied. The purpose of this study was to analyze the Adult to Adult Living Donor Liver Transplantation Study (A2ALL) data to report outcomes of re-LT after LDLT, with a focus on long-term survival after re-LT. METHODS: A retrospective review of A2ALL data collected between 1998 and 2014 was performed. Patients were excluded if they received a deceased donor LT. Demographic data, postoperative outcomes and complications, graft and patient survival, and predictors of re-LT and patient survival were assessed. RESULTS: Of the 1065 patients who underwent LDLT during the study time period, 110 recipients (10.3%) required re-LT. In multivariable analyses, hepatitis C virus, longer length of stay at LDLT, hepatic artery thrombosis, biliary stricture, infection, and disease recurrence were associated with an increased risk of re-LT. Patient survival among re-LT patients was significantly inferior to those who underwent primary transplant only at 1 (86% versus 92%), 5 (64% versus 82%), and 10 years (44% versus 68%). CONCLUSIONS: Approximately 10% of A2ALL patients who underwent primary LDLT required re-LT. Compared with patients who underwent primary LT, survival among re-LT recipients was worse at 1, 5, and 10 years after LT, and re-LT was associated with a significantly increased risk of death in multivariable modeling (hazard ratios, 2.29; P < 0.001).
Authors: B Samstein; A R Smith; C E Freise; M A Zimmerman; T Baker; K M Olthoff; R A Fisher; R M Merion Journal: Am J Transplant Date: 2015-10-13 Impact factor: 8.086
Authors: J F Markmann; J S Markowitz; H Yersiz; M Morrisey; D G Farmer; D A Farmer; J Goss; R Ghobrial; S V McDiarmid; R Stribling; P Martin; L I Goldstein; P Seu; C Shackleton; R W Busuttil Journal: Ann Surg Date: 1997-10 Impact factor: 12.969
Authors: Michael A Zimmerman; Talia Baker; Nathan P Goodrich; Chris Freise; Johnny C Hong; Sean Kumer; Peter Abt; Adrian H Cotterell; Benjamin Samstein; James E Everhart; Robert M Merion Journal: Liver Transpl Date: 2013-03 Impact factor: 5.799
Authors: C E Freise; B W Gillespie; A J Koffron; A S F Lok; T L Pruett; J C Emond; J H Fair; R A Fisher; K M Olthoff; J F Trotter; R M Ghobrial; J E Everhart Journal: Am J Transplant Date: 2008-10-24 Impact factor: 8.086
Authors: Hillary J Braun; Jennifer L Dodge; Joshua D Grab; Shareef M Syed; Garrett R Roll; Chris E Freise; John P Roberts; Nancy L Ascher Journal: Transplantation Date: 2020-02 Impact factor: 5.385