Gastroenterology and Hepatology - Immunology - Infectious Diseases - Public Health and Epidemiology - Surgery
Liver Retransplantation in Adults: The Largest Multicenter Italian Study
Friday, October 05, 2012
by Umberto Maggi, Enzo Andorno, Giorgio Rossi, Luciano De Carlis, Umberto Cillo, Fabrizio Bresadola, Vincenzo Mazzaferro, Andrea Risaliti, Paolo Bertoli, Dario Consonni, Francesco Barretta, Tullia De Feo, Mario Scalamogna
This study is the largest Italian survey on liver retransplantations (RET). Data report on 167 adult patients who received 2 grafts, 16 who received 3 grafts, and one who received 4 grafts over a 11 yr period.
There was no statistically significant difference in graft survival after the first or the second RET (52, 40, and 29% vs 44, 36, and 18% at 1,5,and 10 yr, respectively: Log-Rank test, p?=?0.30).
Survivals at 1, 5, and 10 years of patients who underwent 2 (n?=?151) or 3 (n?=?15) RETs, were 65, 48,and 39% vs 59, 44, and 30%, respectively (p?=?0.59).
Multivariate analysis of survival showed that only the type of graft (whole vs reduced) was associated with a statistically significant difference (HR?=?3.77, Wald test p?=?0. 05); the donor age appeared to be a relevant factor as well, although the difference was not statistically significant (HR?=?1.91, Wald test p?=?0.08).
Though late RETs have better results on long term survival relative to early RETs, no statistically significant difference can be found in early results, till three years after RET.
Considering late first RETs (interval>30 days from previous transplantation) with whole grafts the difference in graft survival in RETs due to HCV recurrence (n?=?17) was not significantly different from RETs due to other causes (n?=?53) (65–58 and 31% vs 66–57 and 28% respectively at 1–5 and 10 years, p?=?0.66).