Detailed Abstract
[E-poster - Liver (Transplantation)]
[EP 001] Long-term Outcomes of Liver Retransplantation: a 31-year Korean Single -center Experiences
Sang-Hoon KIM 1, Deok-Bog MOON 1, Sung-Gyu LEE 1, Shin HWANG 1, Chul-Soo AHN 1, Ki-Hun KIM 1, Tae-Yong HA 1, Gi-Won SONG 1, Dong-Hwan JUNG 1, Gil-Chun PARK 1, Young-In YOON 1, Woo-Hyoung KANG 1, EUN-KYOUNG JWA 1, Byeong-Gon NA 1, Sung Min KIM 1, Rak-kyun OH 1, Hyo Jung KO 1
1 Hepatobiliary Surgery And Liver Transplantation, Asan Medical Center, REPUBLIC OF KOREA
Background : As the number of liver transplant (LT) increases, graft loss is expected to increase. Liver retransplantation (Re-LT) is the only treatment option for patients with liver graft failure. We aimed to identify the post-retransplant long-term outcomes in recipients using living or deceased donor liver grafts and favorable prognostic factors.
Methods : This is a retrospective study of a series of 343 cases of Re-LT for 305 adults and 38 children (<18 years of age) at Asan Medical Center from January 1998 to August 2023. Survival analyses were performed according to recipient type, graft type, allograft dysfunction, time interval from primary to re-LT, technical failure, and preoperative recipient conditions. Univariate and multivariate analyses were evaluated to identify favorable prognostic factors for long-term survival.
Results : The most common cause of re-LT was acute or chronic rejection. Five-year overall survival rates were presented according to recipient type (adult vs. pediatric; 58.6% vs. 78.1), graft type (living vs. deceased; 68.7% vs.58.5%), allograft dysfunction (early vs. chronic; 45.5% vs. 75.1%), time interval from primary to re-LT (>1 year vs. <30 days vs. 1-12 months; 72.1% vs. 45.5% vs. 58.6%), and technical failure (none vs. present; 62.7% vs. 46.9%). Multivariate analysis showed chronic allograft dysfunction, absence of technical failure, preoperative non-ICU admission, absence of sepsis, and low MELD score were favorable prognostic factors.
Conclusions : Considering the poor prognosis of recipient undergoing re-LT in an early period after primary LT, liver transplant surgeon requires to overcome the technical obstacles and intensive post-transplant management, especially for rejection is necessary.
Methods : This is a retrospective study of a series of 343 cases of Re-LT for 305 adults and 38 children (<18 years of age) at Asan Medical Center from January 1998 to August 2023. Survival analyses were performed according to recipient type, graft type, allograft dysfunction, time interval from primary to re-LT, technical failure, and preoperative recipient conditions. Univariate and multivariate analyses were evaluated to identify favorable prognostic factors for long-term survival.
Results : The most common cause of re-LT was acute or chronic rejection. Five-year overall survival rates were presented according to recipient type (adult vs. pediatric; 58.6% vs. 78.1), graft type (living vs. deceased; 68.7% vs.58.5%), allograft dysfunction (early vs. chronic; 45.5% vs. 75.1%), time interval from primary to re-LT (>1 year vs. <30 days vs. 1-12 months; 72.1% vs. 45.5% vs. 58.6%), and technical failure (none vs. present; 62.7% vs. 46.9%). Multivariate analysis showed chronic allograft dysfunction, absence of technical failure, preoperative non-ICU admission, absence of sepsis, and low MELD score were favorable prognostic factors.
Conclusions : Considering the poor prognosis of recipient undergoing re-LT in an early period after primary LT, liver transplant surgeon requires to overcome the technical obstacles and intensive post-transplant management, especially for rejection is necessary.
SESSION
E-poster
E-Session 03/21 ALL DAY