首页 | 本学科首页   官方微博 | 高级检索  
     


Early liver retransplantation in adults
Authors:Abbas Rana  Henrik Petrowsky  Bruce Kaplan  Tun Jie  Marian Porubsky  Shahid Habib  Horacio Rilo  Angelika C. Gruessner  Rainer W. G. Gruessner
Affiliation:1. Division of Abdominal Transplantation, Department of Surgery, University of Arizona, , Tucson, AZ, USA;2. Department of Surgery, Swiss HPB and Transplant Center Zurich, University Hospital Zurich, , Zurich, Switzerland
Abstract:Up to 23% of liver allografts fail post‐transplant. Retransplantation is only the recourse but remains controversial due to inferior outcomes. The objective of our study was to identify high‐risk periods for retransplantation and then compare survival outcomes and risk factors. We performed an analysis of United Network for Organ Sharing (UNOS) data for all adult liver recipients from 2002 through 2011. We analyzed the records of 49 288 recipients; of those, 2714 (5.5%) recipients were retransplanted. Our analysis included multivariate regression with the outcome of retransplantation. The highest retransplantation rates were within the first week (19% of all retransplantation, day 0–7), month (20%, day 8–30), and year (33%, day 31–365). Only retransplantation within the first year (day 0–365) had below standard outcomes. The most significant risk factors were as follows: within the first week, cold ischemia time >16 h [odds ratio (OR) 3.6]; within the first month, use of split allografts (OR 2.9); and within the first year, use of a liver donated after cardiac death (OR 4.9). Each of the three high‐risk periods within the first year had distinct causes of graft failure, risk factors for retransplantation, and survival rates after retransplantation.
Keywords:cause of graft failure  liver retransplantation  multivariate analysis  patient survival  risk factors
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号