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Preliminar y clinical experience in liver retransplantation

摘要BACKGROUND:The past several decades have witnessed increasingly successful rates of liver transplantation. However, retransplantation remains the only choice for patients with irreversible graft failure after primary transplantation. This article aimed to summarize our clinical experience in liver retransplantation. <br> METHODS:From June 2002 to December 2005, a total of 185 cases of liver transplantation including 8 cases of retransplantation were performed in our hospital. The clinical data were analyzed retrospectively. <br> RESULTS:The rate of liver retransplantation was 4.32%. Retransplantation was indicated for the following reasons:biliary complication (3 cases), chronic rejection (2), hepatic artery thrombosis (1), uncontrollable acute rejection (1) and hepatitis B recurrence (1). The mean model of end-stage liver disease (MELD) scores before primary transplantation and retransplantation were 15.6 and 23.9, respectively (P<0.05). The MELD score relfected the severity of liver disease more precisely than the Child classiifcation. The mean interval between the ifrst and second transplantation was 316 days (78-725 days). The ifrst three patients, with mean interval of 101 days, died of severe infection combined with multiple organ failure after retransplantation. The patients who underwent retransplantation more than six months after the ifrst transplant had better outcomes. The one-year survival rate for retransplantation in our group was 62.5%. <br> CONCLUSIONS:Liver retransplantation is the only means of saving the patient with hepatic allograft failure. Understanding of the indications for retransplantation,&nbsp;careful selection of operation timing, excellent surgical skills and meticulous postoperative management all contribute to the success of each case of retransplantation.

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作者单位 Department of Surgery, Centre of 0rgan Transp-lantation, Ruijin Hospital, Medical School of Jiaotong University, Shanghai 200025, China Yan JQ, Peng CH, Li HW, Shen BY, Zhou GW, Yang WP, Chen H, Chen YJ and Shen C [1]
发布时间 2014-12-08
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国际肝胆胰疾病杂志(英文版)

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