title: Reoperations for Intraabdominal Bleeding Following Deceased Donor Liver Transplantation.
abstract: Intraabdominal hemorrhage remains one of the most frequent surgical complications after liver transplantation. The aim of the study was to evaluate risk factors for intraabdominal bleeding requiring reoperation and to assess the relevance of the reoperations with respect to short- and long-term outcomes following liver transplantation.
  
  
  METHODS
  Data of 603 liver transplantations performed in the Department of General, Transplant and Liver Surgery in the period between January 2011 and September 2014 were analyzed retrospectively. Study end-points comprised: reoperation due to bleeding and death during the first 90 postoperative days and between 90 postoperative day and third post-transplant year.
  
  
  RESULTS
  Reoperations for intraabdominal bleeding were performed after 45 out of 603 (7.5%) transplantations. Low pre-transplant hemoglobin was the only independent predictor of reoperation (p=0.002) with the cut-off of 11.3 g/dl. Postoperative 90-day mortality was significantly higher in patients undergoing reoperation as compared to the remaining patients (15.6% vs 5.6%, p=0.008). Post-transplant survival from 90 days to 3 years was non-significantly lower in patients after reoperation for bleeding (83.3%) as compared to the remaining patients (92.2%, p=0.096). Nevertheless, multivariable analyses did not reveal any significant negative impact of reoperations for bleeding on short-term mortality (p=0.589) and 3-year survival (p=0.079).
  
  
  CONCLUSIONS
  Surgical interventions due to postoperative intraabdominal hemorrhage do not appear to affect short- and long-term outcomes following liver transplantation. Preoperative hemoglobin concentration over 11.3 g/dl is associated with decreased risk of this complication, yet the clinical relevance of this phenomenon is doubtful.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Figiel
authors.forename: Michał
authors.initials: M
authors.lastname: Grąt
authors.forename: Karolina M
authors.initials: KM
authors.lastname: Wronka
authors.forename: Waldemar
authors.initials: W
authors.lastname: Patkowski
authors.forename: Maciej
authors.initials: M
authors.lastname: Krasnodębski
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Masior
authors.forename: Jan
authors.initials: J
authors.lastname: Stypułkowski
authors.forename: Karolina
authors.initials: K
authors.lastname: Grąt
authors.forename: Marek
authors.initials: M
authors.lastname: Krawczyk
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011044:Poland; D019106:Postoperative Hemorrhage / Q000209:etiology* / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D014019:Tissue Donors; D016896:Treatment Outcome