title: Retransplantations in the Hungarian liver transplant program.
abstract: Retransplantation of the liver (ReOLT), not infrequent consequence of transplantation, was analyzed from 512 patient records between 1995 and 2012. The 34 cases (33 secondary and 1 tertiary). Of ReOLT all employed cadaveric donor organs. The 34 reOLT were performed in 31 adults and 3 children. The original indication for OLT, among these patients was usually primary sclerosing cholangitis (PSC) and acute liver failure (ALF): there were no alcoholic liver disease (ALD) patients. The indication for early reOLT (within 3 months) was hepatic artery thrombosis while the late reOLTs beyond 3 months after primary transplantation was nonanastomotic biliary stenosis. The cumulative patient versus graft survivals were 61%, 52%, and 52% versus 61%, 52%, and 52% in contrast with primary OLT rates of 81%, 75%, and 70% versus 79%, 72%, and 61% respectively at (P = .03). In conclusion, our data suggested that the characteristics and number of early reOLTs did not change over time. However, the rate of late reOLTs increased. This can be explained by the increased rate of late onset biliary complications in spite of proper interventional radiological treatment. The second conclusion is that hepatitis C virus (HCV) recurrence did not become a main indication among late reOLT. Since a center policy states that patients with an early, cholestatic HCV recurrence are not referred for a secondary transplantation.
authors: Departure of Transplantation and Surgery, Semmelweis University, Budapest, Hungary. Electronic address: abnemes@hotmail.com.
authors: B
authors: B
authors: Nemes
authors: Gy
authors: G
authors: Gaman
authors: E
authors: E
authors: Sárváry
authors: A
authors: A
authors: Doros
authors: D
authors: D
authors: Gorog
authors: I
authors: I
authors: Fehervari
authors: L
authors: L
authors: Kobori
mesh_terms: D000328:Adult; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D002779:Cholestasis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003251:Constriction, Pathologic; D005260:Female; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D006814:Hungary; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D013997:Time Factors; D009927:Tissue and Organ Procurement; D016896:Treatment Outcome; D055815:Young Adult