TY - JOUR
T1 - Liver retransplantation of more than two grafts for recurrent failure
AU - Akpinar, Edip
AU - Selvaggi, Gennaro
AU - Levi, David
AU - Moon, Jang
AU - Nishida, Seigo
AU - Island, Eddie
AU - Defaria, Werviston
AU - Pretto, Ernesto
AU - Ruiz, Philip
AU - Tzakis, Andreas G.
PY - 2009/10/15
Y1 - 2009/10/15
N2 - Background. Transplantation of more than two livers for recurring graft failure has not been specifically addressed in the literature. Methods. A retrospective analysis was conducted from a total of 2527 overall liver transplants at our institution. Main indications for multiple retransplant included primary nonfunction, chronic rejection, hepatic artery thrombosis, and recurrent disease. Results. We identified 39 patients who received more than, two grafts (32 received 3 grafts, 5 received 4 grafts, and 2 received 5 grafts). All patients required interposition arterial grafts from the aorta and hepatojejunostomy for the biliary reconstruction. Seventeen patients are still alive at last follow-up. Perioperative mortality rates after 3rd, 4th, and 5th liver graft were 25%, 14%, and 50%, respectively. Patient and graft survival rates were 72% and 56% at 1 year, respectively. Median length of stay was 27 days and median graft survival, was 2.9 years. Conclusions. Selection of patients and a significant use of available resources are some of the important factors that clinicians need to take into account when dealing with multiple retransplantations. With such conditions, however, liver retransplantation of more than two grafts can be a life-saving procedure.
AB - Background. Transplantation of more than two livers for recurring graft failure has not been specifically addressed in the literature. Methods. A retrospective analysis was conducted from a total of 2527 overall liver transplants at our institution. Main indications for multiple retransplant included primary nonfunction, chronic rejection, hepatic artery thrombosis, and recurrent disease. Results. We identified 39 patients who received more than, two grafts (32 received 3 grafts, 5 received 4 grafts, and 2 received 5 grafts). All patients required interposition arterial grafts from the aorta and hepatojejunostomy for the biliary reconstruction. Seventeen patients are still alive at last follow-up. Perioperative mortality rates after 3rd, 4th, and 5th liver graft were 25%, 14%, and 50%, respectively. Patient and graft survival rates were 72% and 56% at 1 year, respectively. Median length of stay was 27 days and median graft survival, was 2.9 years. Conclusions. Selection of patients and a significant use of available resources are some of the important factors that clinicians need to take into account when dealing with multiple retransplantations. With such conditions, however, liver retransplantation of more than two grafts can be a life-saving procedure.
KW - Hepatitis c
KW - Liver retransplantation
KW - Rejection
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U2 - 10.1097/TP.0b013e3181b6f20e
DO - 10.1097/TP.0b013e3181b6f20e
M3 - Article
C2 - 19935459
AN - SCOPUS:73249136264
VL - 88
SP - 884
EP - 890
JO - Transplantation
JF - Transplantation
SN - 0041-1337
IS - 7
ER -