Modern Outcomes After Liver Retransplantation: A Single-center Experience.

Autor:	Connor AA; Department of Surgery, Houston Methodist Hospital, Houston, TX.; Sherrie and Alan Conover Center for Liver Disease and Transplantation, JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX., Saharia A; Department of Surgery, Houston Methodist Hospital, Houston, TX.; Sherrie and Alan Conover Center for Liver Disease and Transplantation, JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX.; Department of Surgery, Weill Cornell Medical College, New York, NY., Mobley CM; Department of Surgery, Houston Methodist Hospital, Houston, TX.; Sherrie and Alan Conover Center for Liver Disease and Transplantation, JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX.; Department of Surgery, Weill Cornell Medical College, New York, NY., Hobeika MJ; Department of Surgery, Houston Methodist Hospital, Houston, TX.; Sherrie and Alan Conover Center for Liver Disease and Transplantation, JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX.; Department of Surgery, Weill Cornell Medical College, New York, NY., Victor DW 3rd; Department of Surgery, Houston Methodist Hospital, Houston, TX.; Sherrie and Alan Conover Center for Liver Disease and Transplantation, JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX.; Department of Surgery, Weill Cornell Medical College, New York, NY., Kodali S; Department of Surgery, Houston Methodist Hospital, Houston, TX.; Sherrie and Alan Conover Center for Liver Disease and Transplantation, JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX.; Department of Surgery, Weill Cornell Medical College, New York, NY., Brombosz EW; Department of Surgery, Houston Methodist Hospital, Houston, TX., Graviss EA; Department of Surgery, Houston Methodist Hospital, Houston, TX.; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX., Nguyen DT; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX., Moore LW; Department of Surgery, Houston Methodist Hospital, Houston, TX.; Department of Surgery, Weill Cornell Medical College, New York, NY., Gaber AO; Department of Surgery, Houston Methodist Hospital, Houston, TX.; Sherrie and Alan Conover Center for Liver Disease and Transplantation, JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX.; Department of Surgery, Weill Cornell Medical College, New York, NY., Ghobrial RM; Department of Surgery, Houston Methodist Hospital, Houston, TX.; Sherrie and Alan Conover Center for Liver Disease and Transplantation, JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX.; Department of Surgery, Weill Cornell Medical College, New York, NY.
Jazyk:	angličtina
Zdroj:	Transplantation [Transplantation] 2023 Jul 01; Vol. 107 (7), pp. 1513-1523. Date of Electronic Publication: 2023 Jun 20.
DOI:	10.1097/TP.0000000000004500
Abstrakt:	Background: The need for liver retransplantation (reLT) has increased proportionally with greater numbers of liver transplants (LTs) performed, use of marginal donors, degree of recipient preoperative liver dysfunction, and longer survival after LT. However, outcomes following reLT have been historically regarded as poor. Methods: To evaluate reLT in modern recipients, we retrospectively examined our single-center experience. Analysis included 1268 patients undergoing single LT and 68 patients undergoing reLT from January 2008 to December 2021. Results: Pre-LT mechanical ventilation, body mass index at LT, donor-recipient ABO incompatibility, early acute rejection, and length of hospitalization were associated with increased risk of needing reLT following index transplant. Overall and graft survival outcomes in the reLT cohort were equivalent to those after single LT. Mortality after reLT was associated with Kidney Donor Profile Index, national organ sharing at reLT, and LT donor death by anoxia and blood urea nitrogen levels. Survival after reLT was independent of the interval between initial LT and reLT, intraoperative packed red blood cell use, cold ischemia time, and preoperative mechanical ventilation, all previously linked to worse outcomes. Conclusions: These data suggest that reLT is currently a safer option for patients with liver graft failure, with comparable outcomes to primary LT. Competing Interests: The authors declare no funding or conflicts of interest. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu