title: Disease recurrence plays a minor role as a cause for retransplantation after living-donor liver transplantation for primary biliary cirrhosis: A multicenter study in Japan.
abstract: OBJECTIVE
  To clarify the role of disease recurrence as a cause of graft loss after living-donor liver transplantation (LDLT) for primary biliary cirrhosis (PBC), we investigated explant grafts, as well as the native liver and liver biopsy specimens, of patients who underwent retransplantation.
  
  
  METHODS
  Of 516 patients who underwent LDLT for PBC and were registered in the Japanese Liver Transplant Registry, nine patients (1.7%) underwent retransplantation.
  
  
  RESULTS
  Seven patients undergoing retransplantation later than 6 months after primary liver transplantation (LT) were enrolled. All seven patients were female, with ages ranging from 34-57 years, and Model for End-Stage Liver Disease scores ranging 10-28. The right lobe was used as graft in one and the left lobe in six. The initial immunosuppression regimen was tacrolimus in six and cyclosporin in one. The period between the primary LT and retransplantation ranged 11-120 months, with a median of 36 months. Three patients survived and four patients died due to poor graft functions or complications after retransplantation. The primary causes of primary graft loss revealed by histological examination of the explant livers were chronic rejection in three, portal thrombus and/or steatohepatitis in three and outflow block in one. PBC recurrence was observed in 3 and the stage was mild in all.
  
  
  CONCLUSIONS
  PBC recurrence has a small impact as a cause of graft loss after LDLT.
authors.affiliation: Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Egawa
authors.forename: Yasuni
authors.initials: Y
authors.lastname: Nakanuma
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
authors.forename: Susumu
authors.initials: S
authors.lastname: Eguchi
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Sato
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
authors.forename: Mitsuhisa
authors.initials: M
authors.lastname: Takatsuki
authors.forename: Akira
authors.initials: A
authors.lastname: Mori
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Hirohito
authors.initials: H
authors.lastname: Tsubouchi