Liver retransplantation in adults: a single-centre, 25-year experience
Liver retransplantation in adults: a single-centre, 25-year experience
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DOI：
10.1111/j.1477-2574.2010.00162.x
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发表时间：
2010-04-01
期刊：
影响因子：
2.9
通讯作者：
Bramhall, Simon R.
中科院分区：
文献类型：
--
作者：
Marudanayagam, Ravi;Shanmugam, Vivekanandan;Bramhall, Simon R.
背景：再次移植是治疗不可逆移植物衰竭患者的唯一方法。本研究的目的是分析一个单一的中心的经验的适应症和结果的retransplantation.Methods：共196例接受肝再次移植使用225移植物，1982年1月至2007年7月，被纳入本研究。分析了以下参数：患者人口统计学资料;初步诊断;不同时间段内再次移植的分布;再次移植的适应症;再次移植的时间间隔以及患者和移植物的总体存活率。在2437例原发性原位肝移植中，196例（8%）患者需要首次再次移植，23例患者（1%）进行了第二次再移植，6例患者（0.25%）进行了第三次再移植。自身免疫性肝炎是需要再次移植的最常见的主要诊断（占初次移植的12.7%）。再次移植率从我们项目开始时的12%下降到研究期结束时的7.6%。再次肝移植最常见的指征是肝动脉血栓形成（31.6%）。近三分之二的再次移植是在初次移植后6个月内进行的。首次再次移植后1、3、5和10年患者生存率分别为66%、61%、57%和47%。第二次再次移植后的5年生存率为40%。在第三次再次移植后，没有患者存活3年。供体年龄
Background: Retransplantation is the only form of treatment for patients with irreversible graft failure. The aim of this study was to analyse a single centre's experience of the indications for and outcomes of retransplantation.Methods: A total of 196 patients who underwent liver retransplantation using 225 grafts, between January 1982 and July 2007, were included in the study. The following parameters were analysed: patient demographics; primary diagnosis; distribution of retransplantation over different time periods; indications for retransplantation; time interval to retransplantation, and overall patient and graft survival.Results: Of the 2437 primary orthotopic liver transplantations, 196 patients (8%) required a first regraft, 23 patients (1%) a second regraft and six patients (0.25%) a third regraft. Autoimmune hepatitis was the most common primary diagnosis for which retransplantation was required (12.7% of primary transplantations). The retransplantation rate declined from 12% at the beginning of our programme to 7.6% at the end of the study period. The most common indication for retransplantation was hepatic artery thrombosis (31.6%). Nearly two-thirds of the retransplantations were performed within 6 months of the primary transplantation. The 1-, 3-, 5- and 10-year patient survival rates following first retransplantation were 66%, 61%, 57% and 47%, respectively. Five-year survival after second retransplantation was 40%. None of the patients have yet survived 3 years after a third regraft. Donor age of