Skip to main content

Retransplantation of the liver--a seven-year experience.

Publication ,  Journal Article
D'Alessandro, AM; Ploeg, RJ; Knechtle, SJ; Pirsch, JD; Stegall, MD; Hoffmann, R; Sollinger, HW; Belzer, FO; Kalayoglu, M
Published in: Transplantation
May 1993

Three hundred and four patients underwent 362 liver transplants between July 1984 and April 1992. Fifty-eight retransplants were performed in 44 patients (14.5%). Thirty-four patients underwent two (77.3%), seven patients three (15.9%), two patients four (4.5%), and one patient five (2.3%) transplants. Poor function accounted for 23 retransplants (6.4%), technical problems for 19 retransplants (5.2%), and rejection for 15 retransplants (4.1%). One-month patient survivals after retransplantation for poor function, technical problems, or rejection were similar (79.0%, 73.4%, and 80.0%, respectively). No difference in retransplantation rates were seen between adults and children receiving whole liver transplants (WLT) (11.6% versus 19.1%). However, retransplantation for poor function was more common in pediatric recipients receiving reduced-size liver transplants (RLT) (20.0% versus 0.0%, P < 0.01), while retransplantation for hepatic artery thrombosis (HAT) was more common in pediatric recipients receiving WLT (16.7% versus 2.8%, P < 0.05). The presence of multiorgan system failure of greater than four was associated with a high mortality (90%), whereas patients undergoing emergent retransplantation who had less than four systems fail had a survival of 73.9% and patients who underwent elective retransplantation had a survival rate of 81.8%. Length of stay and cost of liver transplantation was higher in patients undergoing retransplantation when compared with primary transplants (29.7 +/- 14.9 days versus 58.4 +/- 38.9 days and $122,358 +/- 59,782 versus $289,302 +/- 126,907, P < 0.01). The overall actuarial one-year patient survival in primary transplants was 86.6% and in retransplants 74.8%, and at five years these were 71.4% versus 62.5%, respectively (P < 0.05). Our results support continued retransplantation of the liver unless the patient's medical condition dictates otherwise.

Duke Scholars

Published In

Transplantation

DOI

ISSN

0041-1337

Publication Date

May 1993

Volume

55

Issue

5

Start / End Page

1083 / 1087

Location

United States

Related Subject Headings

  • Time Factors
  • Survival Rate
  • Surgery
  • Reoperation
  • Liver Transplantation
  • Liver Cirrhosis
  • Infant
  • Humans
  • Hepatitis, Chronic
  • Child, Preschool
 

Citation

APA
Chicago
ICMJE
MLA
NLM
D’Alessandro, A. M., Ploeg, R. J., Knechtle, S. J., Pirsch, J. D., Stegall, M. D., Hoffmann, R., … Kalayoglu, M. (1993). Retransplantation of the liver--a seven-year experience. Transplantation, 55(5), 1083–1087. https://doi.org/10.1097/00007890-199305000-00028
D’Alessandro, A. M., R. J. Ploeg, S. J. Knechtle, J. D. Pirsch, M. D. Stegall, R. Hoffmann, H. W. Sollinger, F. O. Belzer, and M. Kalayoglu. “Retransplantation of the liver--a seven-year experience.Transplantation 55, no. 5 (May 1993): 1083–87. https://doi.org/10.1097/00007890-199305000-00028.
D’Alessandro AM, Ploeg RJ, Knechtle SJ, Pirsch JD, Stegall MD, Hoffmann R, et al. Retransplantation of the liver--a seven-year experience. Transplantation. 1993 May;55(5):1083–7.
D’Alessandro, A. M., et al. “Retransplantation of the liver--a seven-year experience.Transplantation, vol. 55, no. 5, May 1993, pp. 1083–87. Pubmed, doi:10.1097/00007890-199305000-00028.
D’Alessandro AM, Ploeg RJ, Knechtle SJ, Pirsch JD, Stegall MD, Hoffmann R, Sollinger HW, Belzer FO, Kalayoglu M. Retransplantation of the liver--a seven-year experience. Transplantation. 1993 May;55(5):1083–1087.

Published In

Transplantation

DOI

ISSN

0041-1337

Publication Date

May 1993

Volume

55

Issue

5

Start / End Page

1083 / 1087

Location

United States

Related Subject Headings

  • Time Factors
  • Survival Rate
  • Surgery
  • Reoperation
  • Liver Transplantation
  • Liver Cirrhosis
  • Infant
  • Humans
  • Hepatitis, Chronic
  • Child, Preschool