Influence of Selected Factors on Survival After Liver Retransplantation

Abstract

Objective The aim of this study was to examine the survival of adult liver retransplant recipients depending on selected factors: time from the primary transplantation, cold ischemia time, indications for retransplantation, patient age and United Network for Organ Sharing (UNOS) status. Patients and Methods Between December 1989 and March 2011, we performed 43 orthotopic liver retransplantations (re-OLTs) among patients aged 20–62 years including 24 women and 19 men. The cold ischemia time was 250–820 minutes. UNOS status before re-OLT: UNOS 1 (n = 19; 44%) UNOS 2A (n = 15; 35%), and UNOS 2B (n = 4; 9%). The time from OLT to re-OLT was 1–2, 146 days. The indications for re-OLT were arterial thrombosis (n = 14; 33%), anastomotic biliary complication (n = 3; 7%), recurrence of the original disease (n = 9; 21%), hepatic vein thrombosis (n = 1; 2%), primary nonfunction (PNF) dysfunction (n = 2; [5%] /6 [14%]), de novo hepatitis C cirrhosis (n = 2; 5%) and other etiologies (n = 6; 14%). Results The 6-year survival among the primary OLT group was 80% compared with 58% among the re-OLT group ( P = .0001). One-year survivals in the re-OLT group according to UNOS status 1, 2A, and 2B were 47%, 60%, and 75%, respectively ( P = .475). There was a low negative correlation between survival time and time between OLT and re-OLT. There was a low positive correlation between survival time and cold ischemia time. There was a low negative correlation between survival time and patient age. Conclusions There was a significant difference in survival between OLT and re-OLT. There was a correlation between survival time and time to re-OLTx; a shorter time corresponded to longer survival. There was a poor correlation between survival time and patient age. UNOS status before re-OLT and indication for re-OLTx influenced survival.