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 o...

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Bibliographic Details
Published in:Transplantation proceedings 2016-06, Vol.48 (5), p.1717-1720
Main Authors: Masior, Ł, Grąt, M, Krasnodębski, M, Patkowski, W, Figiel, W, Bik, E, Krawczyk, M
Format: Article
Language:English
Subjects:
Adult
Female
Humans
Liver Transplantation - mortality
Male
Middle Aged
Prognosis
Reoperation - mortality
Retrospective Studies
Surgery
Survival Rate
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Summary: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. Patients and 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.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2016.01.055