title: Results of retransplantation for primary nonfunction in a single center.
abstract: BACKGROUND
  Early graft dysfunction has a negative impact on allograft and patient survivals, evolving to retransplantation or death in the majority of cases. The outcome of a second liver transplant is usually worse than the first procedure. Considering the increasing number of recipients on the waiting list, and the discrepancy between the number of accessible donors and recipients, we sought to analyze the results of retransplantation at our institution and at those within the State of Sao Paulo.
  
  
  METHODS
  We reviewed the data of 419 deceased donor transplants on 367 patients from June 2005 to April 2010. Twenty-three patients underwent retransplantation due primary nonfunction (PNF) or early graft dysfunction. The following variables were studied: age, gender, disease that lead to the first transplant, Model for End-Stage Liver Disease (MELD) score on the day before the retransplantation, intensive care unit (ICU) length of stay, and duration of orotracheal intubation (OTI). We compared our patient survival at 30 days and 1 year with that of other patients undergoing retransplantation due to PNF in the Sao Paulo State during the same period.
  
  
  RESULTS
  The majority of patients were females (60.87%), with a mean age of 44.6 years. The etiology that led to our first transplantation was cirrhosis due to hepatitis C virus (HCV; n = 6), followed by acute liver failure, (n = 5). The average of ICU stay was 15.08 days (range, 5-45). The mean MELD score was 34.43 (range, 19-50). The survival was 73.92% and 60.78% at 30 days and 1 year postretransplantation, respectively, whereas for São Paulo State, it was 63.04% and 51.63%, respectively.
authors.affiliation: Liver Transplantation Unit, Hospital Israelita Albert Einstein, Sao Paulo, Brazil. paulavc@einstein.br
authors.forename: M P V
authors.initials: MP
authors.lastname: Coelho
authors.forename: R C
authors.initials: RC
authors.lastname: Afonso
authors.forename: R
authors.initials: R
authors.lastname: Hidalgo
authors.forename: G
authors.initials: G
authors.lastname: Felga
authors.forename: M D
authors.initials: MD
authors.lastname: Almeida
authors.forename: B
authors.initials: B
authors.lastname: Della-Guardia
authors.forename: M B
authors.initials: MB
authors.lastname: Rezende
authors.forename: S P
authors.initials: SP
authors.lastname: Meira-Filho
authors.forename: B H
authors.initials: BH
authors.lastname: Ferraz-Neto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil; D005260:Female; D006085:Graft Survival; D006801:Humans; D007902:Length of Stay; D017093:Liver Failure / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D055815:Young Adult