[Retransplantation for hepatic artery complications after orthotopic liver transplantation].
OBJECTIVE
To evaluate the efficacy and timing of re-transplantation for hepatic artery complications after orthotopic liver transplantation.


METHODS
Between December 2003 and December 2006, the clinical data of 13 patients diagnosed as hepatic artery complications after liver transplantation were retrospectively analyzed.


RESULTS
There were no significant difference in duration of operation and anhepatic phase between the initial transplantation and the second transplantation (P = 0.291, P = 0.312). However, intra-operative blood loss [(3.1 +/- 1.1) L vs. (1.5 +/- 0.9) L, P = 0.005] and intensive care unit stays [(4.3 +/- 1.8) d vs. (3.2 +/- 2.5) d, P = 0.015] were significantly increased in the re-transplant patients. No perioperative mortality occurred. The postoperative mortality of liver re-transplantation was 38.5% (5/13) including acute renal failure in two patients, severe infection in two and heart infarction in one. The other 8 patients were followed from 6 months to 51 months, with a median survival time of 22.5 months.


CONCLUSIONS
Liver re-transplantation is the only viable option for patients with irreversible graft dysfunction secondary to hepatic artery complications after liver transplantation. Proper indication and optimum time of re-transplantation, reasonable individual immunosuppression regime and effective perioperative care program contribute to the increase of the survival rate of the patients performed liver re-transplantation.
Yang
Yang
Y
Liver Transplant Center, Third Affiliated Hospital of Sun Yat-sen University, Transplantation Research Institute of Sun Yat-sen University, Guangzhou 510630, China.
Yi
Hui-min
HM
Wang
Guo-ying
GY
Cai
Chang-jie
CJ
Zeng
Xian-cheng
XC
Lu
Min-qiang
MQ
Li
Hua
H
Xu
Chi
C
Wang
Gen-shu
GS
Yi
Shu-hong
SH
Zhang
Jian
J
Zhang
Jun-feng
JF
Jiang
Nan
N
Chen
Gui-hua
GH
D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006499:Hepatic Artery; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies