title: Evaluation of operative risk in de novo familial amyloid polyneuropathy retransplantation.
abstract: Familial amyloid polyneuropathy (FAP) is the most common hereditary amyloidosis, characterized by progressive peripheral sensory and motor neuropathy. The livers of patients with FAP are used in domino liver transplantation in selected cases to increase the number of grafts available. In our department 10 patients underwent liver retransplantation (ReLTx) in the absence of liver dysfunction by de novo FAP after domino liver transplantation. Our aim was to compare the differences in the consumption of blood products and intraoperative hemodynamic support among patients with FAP undergoing liver transplantation (LTx) and patients with de novo FAP undergoing ReLTx in the same time frame. The anesthetic records of all patients who underwent LTx for FAP and ReLTx for de novo FAP were analyzed, from January 2009 to May 2014. Patients were divided into 2 groups: group 1 patients with FAP, and group 2 patients with de novo FAP. Statistical differences in the value of preoperative creatinine were found. Hemoglobin levels, preoperative international normalized ratio (INR), use of blood products, aminergic support, and surgical time showed no statistical difference. Major bleeding rates would be expected in patients undergoing ReLTx. Changes in renal function, chronic immunosuppressive therapy, and age may contribute to the increase in intraoperative complications. We did not find statistically significant differences, leading us to the conclusion that de novo FAP does not seem to be a predictor of perioperative risk.
authors.affiliation: Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. Electronic address: carolina.ef.rodrigues@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Rodrigues
authors.affiliation: Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: H
authors.initials: H
authors.lastname: Vieira
authors.affiliation: Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: J
authors.initials: J
authors.lastname: Jesus
authors.affiliation: Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: L
authors.initials: L
authors.lastname: Pereira
authors.affiliation: Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: C
authors.initials: C
authors.lastname: Bento
authors.affiliation: Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: C
authors.initials: C
authors.lastname: Seco
authors.affiliation: Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: F
authors.initials: F
authors.lastname: Pinto
authors.affiliation: Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Eufrásio
authors.affiliation: Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: S
authors.initials: S
authors.lastname: Calretas
authors.affiliation: Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: N
authors.initials: N
authors.lastname: Silva
authors.affiliation: Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: J
authors.initials: J
authors.lastname: Ferrão
authors.affiliation: Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: L
authors.initials: L
authors.lastname: Tomé
authors.affiliation: Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Barros
authors.affiliation: Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: D
authors.initials: D
authors.lastname: Diogo
authors.affiliation: Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: E
authors.initials: E
authors.lastname: Furtado
mesh_terms: D000328:Adult; D028227:Amyloid Neuropathies, Familial / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011174:Portugal / Q000453:epidemiology; D011379:Prognosis; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D015996:Survival Rate / Q000639:trends