Liver retransplantation in adults: a 20-year experience of one center in southern Brazil



Título del documento: Liver retransplantation in adults: a 20-year experience of one center in southern Brazil
Revista: Annals of hepatology
Base de datos: PERIÓDICA
Número de sistema: 000415628
ISSN: 1665-2681
Autors: 1
2
3
1
3
3
1
2
1
Institucions: 1Universidade Federal de Ciencias da Saude de Porto Alegre, Programa de Pos-Graduacao em Medicina: Hepatologia, Porto Alegre, Rio Grande do Sul. Brasil
2Universidade Federal de Ciencias da Saude de Porto Alegre, Programa de Gastroenterologia e Hepatologia, Porto Alegre, Rio Grande do Sul. Brasil
3Complexo Hospitalar Santa Casa de Porto Alegre, Porto Alegre, Rio Grande do Sul. Brasil
Any:
Període: Nov-Dic
Volum: 12
Número: 6
Paginació: 942-951
País: México
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Analítico, descriptivo
Resumen en inglés Liver retransplantation (LReTx) is the therapeutic option for hepatic graft failure. Survival after LReTx is poorer than after primary liver transplantation. Given the organ shortage, it is essential to optimize the use of this resource. Objective. To evaluate rates, indications and patient survival after LReTx and identify factors associated with mortality following LReTx. Material and methods. We conducted a retrospective cohort study of all adults undergoing LReTx based on registry data from the Liver Transplantation Group (Complexo Hospitalar Santa Casa de Porto Alegre), southern Brazil. Results. Between June 16, 1991 and July 19, 2011, 824 patients underwent 866 liver transplants. Forty-two procedures corresponded to LReTx (4.8% of all liver transplants performed). Thirty-eight patients who underwent a single LReTx procedure were included in this study. The leading indication for LReTx was hepatic artery thrombosis (HAT) (31.6%), followed by primary nonfunction (PNF) (18.4%). The main indication for early LReTx was PNF (58.3%) and for late LReTx was HAT (38.5%). During the follow-up period, 26 patients (68.4%) died after LReTx. Patient survival at 1 and 3 years after LReTx was 44.7% and 44.7%, respectively. Patients infected with hepatitis C virus, serum albumin < 2.5 g/dL and receiving mechanical ventilation immediately before LReTx had a significantly lower survival rate than the other patients. Conclusion. Considering the increased mortality when the graft loss is delayed, it is necessary to define the minimum acceptable results to indicate LReTx and identify the patients who would most benefit from this treatment
Disciplines Medicina
Paraules clau: Cirugía,
Gastroenterología,
Trasplante de hígado,
Mortalidad,
Tasa de sobrevivencia
Keyword: Medicine,
Gastroenterology,
Surgery,
Liver transplantation,
Mortality,
Survival rate
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