When Living Donor Liver Allografts Fail: Exploring the Outcomes of Retransplantation Using Deceased Donors

T. Bittermann, A. Shaked, D. S. Goldberg

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Outcomes of retransplantation after initial living donor liver transplantation (LDLT) are poorly understood. The aim of this study is to better understand the indications, timing, and outcomes of retransplantation after initial LDLT when compared to after initial deceased donor transplantation (DDLT). From 2002 to 2013, 209 retransplant recipients after initial LDLT and 2893 after initial DDLT were identified in Organ Procurement and Transplantation Network/United Network for Organ Sharing. Multivariable logistic models evaluated the association between initial transplant type and 1-year mortality. The most frequent reason for early graft failure (≤14 days) in LDLT recipients was vascular thrombosis (63.6%) versus primary graft failure in initial DDLT recipients (59.1%). LDLT recipients were more often acutely and/or critically ill with a greater proportion of Status 1 (42.6% vs. 27.3%; p < 0.001) and intensive care unit (52.2% vs. 39.9%; p = 0.001) recipients at the time of retransplantation. There was no difference in adjusted 1-year mortality between retransplant recipients after initial LDLT versus DDLT (odds ratio 0.74; 95% confidence interval 0.51–1.08). The proportion of recipients who ultimately required retransplantation for a third time was not different between the two groups (4.8%). Retransplantation outcomes after LDLT are not different from other retransplant procedures, despite recipients having greater acuity of illness and different indications.

Original languageEnglish (US)
Pages (from-to)1097-1102
Number of pages6
JournalAmerican Journal of Transplantation
Volume17
Issue number4
DOIs
StatePublished - Apr 1 2017
Externally publishedYes

Keywords

  • clinical research/practice
  • liver transplantation/hepatology
  • liver transplantation: living donor
  • patient characteristics
  • retransplantation

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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