Incidence of liver retransplantation and its effect on patient survival.
OBJECTIVE
The purpose of this study was to review our institutional experience with re-liver transplantation (OLT) after split and full-size OLT.


METHODS
We evaluated data corresponding to retransplanted patients over an 8-year period who underwent deceased donor OLT at our institution. Variables analyzed included indications for primary OLT, and re-OLT, the type of graft used during the initial versus re-OLT, the time from initial to re-OLT, and patient survival after re-OLT.


RESULTS
Sixty-four of 697 first OLT (9.2%) required re-OLT. Forty-nine cases were among 637 (7.6%) full-size OLT, while 15 were among 60 (25%) split OLT (P < .001). Median time to re-OLT was 8 days (range = 1-1885 days). Main indications for re-OLT were primary nonfunction/initial poor function (44%), hepatic artery thrombosis (26%), biliary complications (11%), and hepatitis C recurrence (6%). Forty-eight percent of the re-OLTs were performed within the first posttransplant week. The overall survival for these 64 patients was 55% and 48% at 1 and 3 years after the primary OLT, and 44% at both 1 and 3 years after the re-OLT, respectively.


CONCLUSIONS
The overall incidence of re-OLT remains 9%. Approximately half of all re-OLT occured within the first posttransplant week. Early retransplantation was associated with the best patient survival. Overall survival after re-OLT was about 10% to 20% lower than that after primary OLT.
Lang
H
H
Department of General and Abdominal Surgery, Johannes Gutenberg University Hospital, Mainz, Germany; Department of General, Visceral, and Transplantation Surgery, University Hospital Essen, Essen, Germany. lang@ach.klinik.uni-mainz.de
Sotiropoulos
G C
GC
Beckebaum
S
S
Fouzas
I
I
Molmenti
E P
EP
Omar
O S
OS
Sgourakis
G
G
Radtke
A
A
Nadalin
S
S
Saner
F H
FH
Malagó
M
M
Gerken
G
G
Paul
A
A
Broelsch
C E
CE
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012086:Reoperation / Q000401:mortality / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D015996:Survival Rate; D017741:Survivors; D055815:Young Adult