title: Liver recipients undergoing hepatic transplantation and subsequent retransplantation: a comparison between clinical characteristics.
abstract: OBJECTIVE
  In order to establish a rational strategy for organ distribution and optimal patient management, we postulate it is mandatory not only to understand the pathophysiology of failing grafts but also to better recognize the baseline clinical characteristics of the recipients shortly before receiving a second liver allograft.
  
  
  METHODS
  Between March 1986 and December 1997, 1061 patients underwent 1087 orthotopic liver transplantation at three Hospitals in Madrid (122 retransplants).
  
  
  RESULTS
  Mean follow-up was 36 months (range, 1-90), 40.6% of the recipients were alive and survival at 1, 3 and 5 years was 62%, 53%, and 46%. Almost 50% of the recipients were UNOS 1 before retransplantation. In comparison to p-OLT (15% UNOS 1), it is clearly shown that the retransplants have been performed in the sickest patients with more adverse prognostic indicators (higher AST, bilirubin, creatinine serum levels, higher Child-Pugh score, higher rate of ascites and lower serum levels of albumin and prothrombin activity).
  
  
  CONCLUSIONS
  Liver retransplantation is acceptable and significant differences in recipients' baseline characteristics suggest an impact on lower survival.
authors.affiliation: University Hospital 12 de Octubre, Department of General, Digestive and Abdominal Organs Transplantation, Madrid, Spain. jcmeneu@hotmail.com
authors.forename: J C
authors.initials: JC
authors.lastname: Meneu-Diaz
authors.forename: E
authors.initials: E
authors.lastname: Moreno Gonzalez
authors.forename: A
authors.initials: A
authors.lastname: Moreno Elola-Olaso
authors.forename: E Vicente
authors.initials: EV
authors.lastname: Lopez
authors.forename: J
authors.initials: J
authors.lastname: Nuño Vazquez
authors.forename: C
authors.initials: C
authors.lastname: Jimenez
authors.forename: V
authors.initials: V
authors.lastname: Turrion
authors.forename: C
authors.initials: C
authors.lastname: Loinaz
authors.forename: R
authors.initials: R
authors.lastname: Gomez
authors.forename: M
authors.initials: M
authors.lastname: Abradelo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D019091:Critical Pathways; D003627:Data Interpretation, Statistical; D004359:Drug Therapy, Combination; D005260:Female; D006084:Graft Rejection / Q000145:classification / Q000401:mortality / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D017093:Liver Failure / Q000145:classification / Q000401:mortality / Q000601:surgery*; D008111:Liver Function Tests / Q000145:classification; D016031:Liver Transplantation; D008297:Male; D008432:Mathematical Computing; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification / Q000401:mortality / Q000601:surgery*; D011379:Prognosis; D012086:Reoperation / Q000401:mortality; D013030:Spain; D015996:Survival Rate; D014019:Tissue Donors / Q000600:supply & distribution
chemical_list: D007166:Immunosuppressive Agents