[Clinical study of liver re-transplantation]

Abstract

Objective: To report experiences of liver re-transplantation.

Methods: The cause of re-transplantation, the pre-operative MELD score, timing of re-transplantation, technical considerations, 1 year survival rate and the causes of death of the patients receiving liver re-transplantation in First Central Hospital of Tianjin between January 1999 and December 2005 were retrospectively analyzed.

Results: One year survival rate of re-transplantation was 71.6%. The most common cause of hepatic graft failure and subsequent re-transplantation was biliary complications (45.5%). The 1 year survival rate of patients with a MELD score less than 20 was higher than patients with a score of 20 approximately 30 and > 30 (83.8% versus 57.1% and 66.7%). The peri-operative survival rate of patients who received re-transplantation 30 days after the initial transplantation was higher than those who received re-transplantation between 8 to 30 days post the first operation (83.8% versus 41.7%). The main cause of peri-operative death was celiac infections (accounted for 54.2% deaths) in the patients.

Conclusions: Proper indication selection, optimum operation time, right surgical procedure, intensified peri-operative monitoring and infection control are all crucial for the improvement of survival rate in patients receiving liver re-transplantation.