title: Prognostic Factors and Outcomes of Patients After Liver Retransplantation.
abstract: BACKGROUND
  Despite great progress and improvement in results of orthotopic liver transplantation (OLTx), 10%-20% of patients still require retransplantation (re-OLTx). The aim of the study was to present long-term results of liver retransplantation and to determine the factors influencing outcomes.
  
  
  METHODS
  From December 1994 to July 2014, a total of 1461 liver transplantations were performed in the Department of General, Transplant and Liver Surgery of Medical University of Warsaw. There were 92 retransplantations (6.3%), including 40 early re-OLTx (up to 30 days). The most common indication for re-OLTx were vascular complications (41/92, 44.6%). Influence of clinical variables on short- and long-term outcomes was analyzed.
  
  
  RESULTS
  Postoperative mortality was 30.4% (28/92). One-year, 3-year and 5-year survival for all patients was 59.8%, 56.5% and 54.1%, respectively. The best results were achieved in patients undergoing retransplantation due to chronic rejection and biliary complications, whose 5-year survival rates were 75.0% and 72.9% respectively. There was no difference in long-term survival after early and late retransplantations (60.9% and 49.3%, respectively; P = .158). Multivariable analysis revealed factors associated with longer survival of patients, namely, higher preoperative hemoglobin concentration (P = .001), increased blood transfusions (P = .048), and decreased fresh frozen plasma transfusions (P = .004).
  
  
  CONCLUSIONS
  Liver retransplantation is a method providing satisfactory outcomes in selected patients. The perioperative period has a major impact on patient outcome.
authors: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Electronic address: lmasior@gmail.com.
authors: Ł
authors: Ł
authors: Masior
authors: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
authors: M
authors: M
authors: Grąt
authors: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
authors: M
authors: M
authors: Krasnodębski
authors: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
authors: W
authors: W
authors: Patkowski
authors: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
authors: W
authors: W
authors: Figiel
authors: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
authors: E
authors: E
authors: Bik
authors: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
authors: M
authors: M
authors: Krawczyk
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012086:Reoperation / Q000401:mortality*; D012189:Retrospective Studies; D015996:Survival Rate