Indications for and Results of Liver Retransplantation.

Moya A, Torres-Quevedo R, San Juan F, Montalvá E, López-Andújar R, Pareja E, De Juan M, Vila JJ, Berenguer M, Aguilera V, Mir J.

Clinical Transplants 2009, Chapter 13

Summary

Liver retransplantation (LRT) is the only therapeutic option for the irreversible failure of a hepatic graft. The aim of this study was to evaluate our rate, indications, postoperative morbidity and mortality and patient survival at one and 5 years after LRT. 1,260 liver transplants (LT) were performed between 1991 and 2006, 79 were LRT (6.3%). During the first LT, there were no apparent differences between patients who did or did not require LRT. The most common reasons for LRT were hepatic artery thrombosis (31.6%), recurrence of hepatitis C virus cirrhosis (30.4%) and primary graft non function (21.5%). The actuarial survival rates at one and 5 years were 83% and 69% among those without LRT versus 71% and 61% among those with early LRT, and 64% and 34% among those with late LRT (p < 0.001). Although high morbidity and mortality were associated with LRT, it seems that this therapeutic option is valid for patients with early hepatic loss, although not when the graft loss is late. It becomes necessary to define the minimal acceptable results so that patients can benefit from LRT.