Analysis of Liver Retransplantation in 62 Cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WU Fengdong ,  ZANG Yunjin , SHEN Zhongyang

The Institute of Liver Transplantation， General Hospital of Chinese People’s Armed Police Forces， Beijing 100039， China;

Corresponding author：

ZANG Yunjin, Email: zangyunjin@gmail.com

Keywords：

Liver transplantation; Reoperation; Prognosis

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective 　To summary the clinical experience of liver retransplantation （RLT）， and to improve the effect.
Methods 　The clinical data of 62 cases who had received RLT in our institute from Jan. 2003 to Jun. 2012 were analyzed retrospectively. The survival rates of patients with different interval between two liver transplantation （LT） were calculated， and the data of patients who died and survived during perioperative period after operation were compared and analyzed.
Results 　The 1-， 2-， and 5-year cumulative survival rates of 62 patients were 67.7%， 59.7%， and 56.4%， of early stage RLT patients were 38.5%， 38.5%， and 30.8%， of later stage RLT patients were 75.5%， 65.3%， and 63.3%， respectively. There were 28 patients died after operation， and 20 patients （71.4%） died during perioperative period， whose major cause of death were infection （65.0%， 13/20）， in addition， 4 cases （20.0%） died of multiple organ failure， 2 cased （10.0%） died of hepatic artery complication， 1 case （5.0%） died of portal vein complication. Eight cases （28.6%） died after perioperative period in reason of tumor recurrence. The model for end-stage liver disease （MELD） score 〔（26.95±9.28） score vs. （14.23±9.06） score〕， creatinine （Cr） level 〔（157.3±88.0） μmol/L vs.（69.8±35.9） μmol/L〕， international normalized ratio （INR） value 〔（1.676±0.744） vs.（1.124±0.286）〕， and total bilirubin （TBiL） value 〔431.8 μmol/L vs. 248.2 μmol/L〕 of patients died during perioperative period were higher than that of patients survived after perioperative period （P＜0.05）. The ratio of abnormal Cr of patients died during perioperative
period and survived after perioperative period were 60.0% （12/20） and 7.1% （3/42）， respectively. The 34 patients who had survived after perioperative period were all got followed-up for 3-104 months （average 49 months）. There were no tumor recurrence during the followed-up， and liver function of them were normal.
Conclusions 　RLT is an effective method for irreversible graft failure after LT. Optimum operative time and reasonable individual immunosuppressive regimen to decrease the infection rate are all contribute to the increase of the survival rate.

Citation： WU Fengdong,ZANG Yunjin,SHEN Zhongyang,.. Analysis of Liver Retransplantation in 62 Cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(3): 246-250. doi: Copy

1.	Watt KD， Lyden ER， Mccashland TM. Poor survival after liver retransplantation：is hepatitis C to blame?[J]. Liver Transpl， 2003， 9(10)：1019-1024.
2.	Marudanayagam R， Shanmugam V， Sandhu B， et al. Liver retrans-plantation in adults：a single-centre， 25-year experience[J]. HPB(Oxford)， 2010， 12(3)：217-224.
3.	Benson AB， Burton JR Jr， Austin GL， et al. Differential effects of plasma and red blood cell transfusions on acute lung injury and infection risk following liver transplantation[J]. Liver Transpl， 2011， 17(2)：149-158.
4.	Yang SC， Chen CL， Wang CH， et al. Intraoperative blood and fluid administration differences in primary liver transplantation versus liver retransplantation[J]. Acta Anaesthesiol Taiwan， 2011， 49(2)：50-53.
5.	Remiszewski P， Kalinowski P， Dudek K， et al. Influence ofselected factors on survival after liver retransplantation[J]. Transplant Proc， 2011， 43(8)：3025-3028.
6.	Chen GH， Fu BS， Cai CJ， et al. A single-center experience of retransplantation for liver transplant recipients with a failing graft[J]. Transplant Proc， 2008， 40(5)：1485-1487.
7.	Crivellin C， De Martin E， Germani G， et al. Risk factors in liver retransplantation：a single-center experience[J]. Transplant Proc， 2011， 43(4)：1110-1113.
8.	Ponton C， Vizcaíno L， Tomé S， et al. Improvement of renal function after conversion to mycophenolate mofetil combined with low-level calcineurin inhibitor in liver transplant recipients with chronic renal dysfunction[J]. Transplant Proc， 2010， 42(2)：656-659.
9.	Kim JM， Joh JW， Kim SJ， et al. Steroid withdrawal in adult livertransplantation：occurrence at a single center[J]. Transplant Proc， 2010， 42(10)：4132-4136.

1. Watt KD， Lyden ER， Mccashland TM. Poor survival after liver retransplantation：is hepatitis C to blame?[J]. Liver Transpl， 2003， 9(10)：1019-1024.
2. Marudanayagam R， Shanmugam V， Sandhu B， et al. Liver retrans-plantation in adults：a single-centre， 25-year experience[J]. HPB(Oxford)， 2010， 12(3)：217-224.
3. Benson AB， Burton JR Jr， Austin GL， et al. Differential effects of plasma and red blood cell transfusions on acute lung injury and infection risk following liver transplantation[J]. Liver Transpl， 2011， 17(2)：149-158.
4. Yang SC， Chen CL， Wang CH， et al. Intraoperative blood and fluid administration differences in primary liver transplantation versus liver retransplantation[J]. Acta Anaesthesiol Taiwan， 2011， 49(2)：50-53.
5. Remiszewski P， Kalinowski P， Dudek K， et al. Influence ofselected factors on survival after liver retransplantation[J]. Transplant Proc， 2011， 43(8)：3025-3028.
6. Chen GH， Fu BS， Cai CJ， et al. A single-center experience of retransplantation for liver transplant recipients with a failing graft[J]. Transplant Proc， 2008， 40(5)：1485-1487.
7. Crivellin C， De Martin E， Germani G， et al. Risk factors in liver retransplantation：a single-center experience[J]. Transplant Proc， 2011， 43(4)：1110-1113.
8. Ponton C， Vizcaíno L， Tomé S， et al. Improvement of renal function after conversion to mycophenolate mofetil combined with low-level calcineurin inhibitor in liver transplant recipients with chronic renal dysfunction[J]. Transplant Proc， 2010， 42(2)：656-659.
9. Kim JM， Joh JW， Kim SJ， et al. Steroid withdrawal in adult livertransplantation：occurrence at a single center[J]. Transplant Proc， 2010， 42(10)：4132-4136.

Next Article
胸外科围手术期气道管理专家共识（2012年版）

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of Liver Retransplantation in 62 Cases

Abstract Full text Figures/Tables Video References Cited by

Next Article

Format

Content