| Revue: | Annals of hepatology |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000406024 |
| ISSN: | 1665-2681 |
| Autores: | Shah, Jigesh A1 Patel, Madhukar S1 Kratz, Johannes R2 Markmann, James F1 Vagefi, Parsia A1 |
| Instituciones: | 1Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts. Estados Unidos de América 2University of California at San Francisco, San Francisco, California. Estados Unidos de América |
| Año: | 2016 |
| Periodo: | Nov-Dic |
| Volumen: | 15 |
| Número: | 6 |
| Paginación: | 888-894 |
| País: | México |
| Idioma: | Inglés |
| Tipo de documento: | Artículo |
| Enfoque: | Analítico, descriptivo |
| Resumen en inglés | Liver re-transplantation (re-OLT) remains the only feasible option for patients with graft failure following liver transplantation. Sparse resources and a growing waitlist mandate that available grafts are allocated properly. We studied the differences in patient demographics, characteristics, and survival for those listed for re-OLT in a region with prolonged wait times. Material Material andmethods. methods. We methods. performed a single-center retrospective study, from 2005 to 2013, of adult candidates listed for liver re-OLT at a tertiary care center within United Network for Organ Sharing (UNOS) region 1. Results. Results. Of Results. the 48 patients listed for re-OLT, 1(2%) improved while waiting, 14(29%) died while waiting, and 33(69%) underwent re-OLT. Those re-transplanted represented 11% of the center’s adult liver transplant volume during the same time period. Comparing those who died while waiting to those who achieved re-OLT, there was no significant difference in age (median 52 vs. 48 years, p=0.56) or MELD at second listing (median 29 vs. 26, p = 0.90). Waitlisted candidates who failed to achieve re-transplant died on average of 15.5 days (IQR 36 days) days after re-listing. Those re-transplanted achieved 3-year survival of 70% and there was no significant difference in 3-year survival of those re-transplanted within or beyond 90 days of first transplant (70% vs. 69.5%, p = 0.28). Conclusions. Conclusions. Conclusions. In conclusion, re-OLT is the only viable option for candidates with nonreversible liver graft failure. Inability to achieve re-OLT leads to nearly assured and expeditious death. Despite technical challenges, in experienced hands excellent long term survival following re-OLT can be achieved |
| Disciplinas: | Medicina |
| Palabras clave: | Cirugía, Gastroenterología, Terapéutica y rehabilitación, Trasplante de hígado, Rechazo, Selección de pacientes |
| Keyword: | Medicine, Gastroenterology, Surgery, Therapeutics and rehabilitation, Liver transplantation, Rejection, Patients selection |
| Texte intégral: | Texto completo (Ver PDF) |
