title: [Experiences of liver retransplantation for postoperative diffuse biliary strictures].
abstract: OBJECTIVE
  To investigate the feasibility and management of retransplantation for diffuse biliary strictures occurring after initial liver transplantation.
  
  
  METHODS
  The clinical data of 53 consecutive liver retransplantation patients at our hospital from January 2001 to December 2009 were collected and analyzed retrospectively. Among them, 20 (37.7%) were due to diffuse biliary strictures.
  
  
  RESULTS
  Diffuse biliary strictures appeared at 3 - 16 months after initial transplantation. The mean time was 6.3 months. The specific types included intra-hepatic diffuse biliary strictures (n = 16) and multi-strictures involving both intra- & extra-hepatic biliary ducts (n = 4). Retransplantation was performed after a failure of intervention or/and other comprehensive treatments. Among them, 14 were cured and 6 died from peri-operative complications including serious abdominal infection & MODS (multiple organ dysfunction syndrome) (n = 3, 50%), biliary fistula (n = 2, 33.3%) and hepatic artery embolism (n = 1, 16.7%). These patients were followed up for a mean time of 1.8 years (range: 1 - 5 years). The accumulative survival rates at 1, 3 and 6 months were 80.0%, 75.0% and 70.0% respectively.
  
  
  CONCLUSIONS
  Liver retransplantation is the ultimate treatment for diffuse biliary strictures after liver transplantation. The survival rate is associated with operative timing, surgical techniques and peri-operative management.
authors.affiliation: Sun Yat-sen University, Guangzhou 510080, China. anhuimayi2002@163.com
authors.forename: Yi
authors.initials: Y
authors.lastname: Ma
authors.forename: Xiao-shun
authors.initials: XS
authors.lastname: He
authors.forename: Xiao-feng
authors.initials: XF
authors.lastname: Zhu
authors.forename: Dong-ping
authors.initials: DP
authors.lastname: Wang
authors.forename: Guo-dong
authors.initials: GD
authors.lastname: Wang
authors.forename: An-bin
authors.initials: AB
authors.lastname: Hu
authors.forename: Wei-qiang
authors.initials: WQ
authors.lastname: Ju
authors.forename: Lin-wei
authors.initials: LW
authors.lastname: Wu
authors.forename: Qiang
authors.initials: Q
authors.lastname: Tai
authors.forename: Zhi-yong
authors.initials: ZY
authors.lastname: Guo
mesh_terms: D000328:Adult; D000368:Aged; D001649:Bile Duct Diseases / Q000209:etiology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult