title: Incidence of liver retransplantation and its effect on patient survival.
abstract: 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.
authors.affiliation: 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
authors.forename: H
authors.initials: H
authors.lastname: Lang
authors.forename: G C
authors.initials: GC
authors.lastname: Sotiropoulos
authors.forename: S
authors.initials: S
authors.lastname: Beckebaum
authors.forename: I
authors.initials: I
authors.lastname: Fouzas
authors.forename: E P
authors.initials: EP
authors.lastname: Molmenti
authors.forename: O S
authors.initials: OS
authors.lastname: Omar
authors.forename: G
authors.initials: G
authors.lastname: Sgourakis
authors.forename: A
authors.initials: A
authors.lastname: Radtke
authors.forename: S
authors.initials: S
authors.lastname: Nadalin
authors.forename: F H
authors.initials: FH
authors.lastname: Saner
authors.forename: M
authors.initials: M
authors.lastname: Malagó
authors.forename: G
authors.initials: G
authors.lastname: Gerken
authors.forename: A
authors.initials: A
authors.lastname: Paul
authors.forename: C E
authors.initials: CE
authors.lastname: Broelsch
mesh_terms: 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