Liver recipients undergoing hepatic transplantation and subsequent retransplantation: a comparison between clinical characteristics.
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.
Meneu-Diaz
J C
JC
University Hospital 12 de Octubre, Department of General, Digestive and Abdominal Organs Transplantation, Madrid, Spain. jcmeneu@hotmail.com
Moreno Gonzalez
E
E
Moreno Elola-Olaso
A
A
Lopez
E Vicente
EV
Nuño Vazquez
J
J
Jimenez
C
C
Turrion
V
V
Loinaz
C
C
Gomez
R
R
Abradelo
M
M
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
D007166:Immunosuppressive Agents