Liver retransplantation: indications and results over a 15-year experience

Predictors of Long-Term Survival After Liver Transplantation for Hepatocellular Carcinoma

“…In patients with Child C cirrhosis, the diagnosis of HCC was based on the imaging evidence of focal liver lesion (with arterial hypervascularization) on at least two imaging techniques. Tumor stages were established by US, an- Liver transplantation was performed as described elsewhere (9).…”

Trends and experiences in liver retransplantation over 15 years

“…Over the last 2 decades, liver transplantation (LT) has developed into a successful standard surgical therapy for terminal liver failure,1–3 showing 1‐year survival rates of over 80% and 5‐year survival rates of over 70% in experienced centers 4–7. Despite this success, liver retransplantation (re‐LT) shows significantly inferior results,3, 6, 8–24 and for the majority of patients, re‐LT remains the only alternative to death. The main reasons for poor outcome after re‐LT are infections during the early postoperative period with septic complications, multiorgan failure,3, 12, 13, 17–19, 23, 24 and bleeding complications,3, 13, 16, 17, 19 and during the late course, predominant factors are recurrence of the disease and chronic rejection 3, 7, 8, 11, 16.…”

“…Despite this success, liver retransplantation (re‐LT) shows significantly inferior results,3, 6, 8–24 and for the majority of patients, re‐LT remains the only alternative to death. The main reasons for poor outcome after re‐LT are infections during the early postoperative period with septic complications, multiorgan failure,3, 12, 13, 17–19, 23, 24 and bleeding complications,3, 13, 16, 17, 19 and during the late course, predominant factors are recurrence of the disease and chronic rejection 3, 7, 8, 11, 16. On the one hand, because more than 50% of deaths after re‐LT occur within the first 3 months,3, 8, 9, 12 it is important to evaluate prognostic factors and therapeutic strategies to influence outcome during this period 24–29.…”

“…To date, re‐LT accounts for 5 to 22% of all LT in adults 3, 9, 10–12, 13, 17, 18, 21. Moreover, retransplantation arouses controversy in the medical, economical, and ethical fields,8, 9, 23, 24 because patient and graft survival rates after re‐LT are less successful compared to those after primary transplantation,3, 6, 8–22, 24 the procedure is more expensive,9, 10, 22 and in the context of organ shortage re‐LT inevitably denies organs to first‐time recipients who have the same legal claim to their first donor organ 24. To identify predictors, changes in indications, and trends of survival, and to find therapeutic approaches for clinical practice of re‐LT, we investigated in a retrospective analysis at the Virchow Clinic the clinical results and outcomes of 119 re‐LT recipients over a period of 15 years.…”

Successful Hepatoatrial Anastomosis During a Consecutive Liver Retransplant in the Same Patient Shows Good Long-Term Results: Case Report and 2-Year Follow-Up

“…Our clinical results are similar to those reported in the literature. [11][12][13] This patient was retransplanted almost 1 year from the previous liver retransplant. Influenced by experience coming from other centers, we postponed the liver retransplant by nearly half a year so as to achieve a better outcome.…”