Indications for and results of liver retransplantation.
Liver retransplantation (LReTx) is the therapeutic option for the irreversible failure of a hepatic graft. Our aim was to evaluate the rate of and indications for LReTx and actuarial patient survivals. Among 1260 LTx were 79 LReTx (6.3%). During the first LTx, there were no apparent differences between patients who did or did not required LReTx. The most frequent reasons were hepatic artery thrombosis (31.6%), recurrence of the VHC cirrhosis (30.4%), and primary graft failure (21.5%). The actuarial survivals at 1 and 5 years were 83% and 69% among those without LReTx versus 71% and 61% among early LReTx, and 64% and 34% among late LReTx (P < .001). Although there exists high morbidity and mortality with LReTx, it seems that this therapeutic alternative continues to be valid for patients with early hepatic loss, but not when the graft loss was late. It becomes necessary to define the minimal acceptable results that patient can benefit from LReTx.
Unit of Surgery and Liver Transplantation, University Hospital La Fe, Valencia, Spain. rtorresquevedo@yahoo.es
R
R
Torres-Quevedo
A
A
Moya-Herraiz
F
F
San Juan
R
R
López-Andujar
E
E
Montalva
E
E
Pareja
M
M
De Juan
J J
JJ
Vila
V
V
Aguilera
R
R
Pina
M
M
Berenguer
M
M
Prieto
J
J
Mir
D015331:Cohort Studies; D005500:Follow-Up Studies; D006499:Hepatic Artery / Q000473:pathology; D006526:Hepatitis C / Q000150:complications / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000401:mortality / Q000601:surgery / Q000821:virology; D016031:Liver Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D018579:Patient Selection; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data*; D016019:Survival Analysis; D017741:Survivors; D013927:Thrombosis / Q000401:mortality / Q000601:surgery*; D013997:Time Factors; D017211:Treatment Failure