López María Josefa Cuevas, Franco Carmen Cepeda, Artacho Gonzalo Suárez, Gómez Luis Miguel Marín, Bellido Carmen Bernal, Martínez José María Álamo, Ruiz Francisco Javier Padillo, Bravo Miguel Ángel Gómez
Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen del Rocío, Seville, Spain.
Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen del Rocío, Seville, Spain.
Transplant Proc. 2020 Jun;52(5):1486-1488. doi: 10.1016/j.transproceed.2020.02.055. Epub 2020 Mar 19.
Liver retransplantation can be classified as urgent (when performed in the first week after the transplantation) or elective, which may be considered as early (first month post-transplantation) or late (after the first month). The time in which retransplantation takes place is determined by the cause that makes it necessary. The goal of this study is to analyze the causes and results of early retransplantation in our center.
A retrospective analysis of liver retransplantations performed within the first month after the original transplantation in our center between 2007 and 2017 was carried out. The variables analyzed were demographic, causes of the first transplant and retransplantation, and the complications and mortality resulting from the latter.
A total of 698 liver transplants were performed, including 67 patients who required retransplantation (8.9%). Among these, 37 were late elective retransplantations and 30 were early retransplantations. Regarding the latter, the causes that led to the first transplant were hepatocellular carcinoma (46.7%) and noncholestatic cirrhosis (30%). On the other hand, the main precipitants of the retransplantation were hepatic artery thrombosis (60%) and primary graft failure (13.3%). The reoperation rate was 16.7%, and the perioperative mortality rate was 16.7%. The 1-, 2-, and 5-year survival rates were 83.3%, 76.7% and 59.9%, respectively.
Despite the high perioperative morbidity of liver retransplantation, its results in terms of survival are similar to those of the global series of liver transplantation.
肝再次移植可分为紧急情况（在移植后第一周内进行）或择期移植，择期移植又可分为早期（移植后第一个月）或晚期（第一个月之后）。再次移植的时间取决于需要进行再次移植的原因。本研究的目的是分析我们中心早期再次移植的原因及结果。
对2007年至2017年期间在我们中心首次移植后第一个月内进行的肝再次移植进行回顾性分析。分析的变量包括人口统计学数据、首次移植和再次移植的原因，以及再次移植导致的并发症和死亡率。
共进行了698例肝移植，其中67例患者需要再次移植（8.9%）。其中，37例为晚期择期再次移植，30例为早期再次移植。对于后者，导致首次移植的原因是肝细胞癌（46.7%）和非胆汁淤积性肝硬化（30%）。另一方面，再次移植的主要促成因素是肝动脉血栓形成（60%）和原发性移植物功能衰竭（13.3%）。再次手术率为16.7%，围手术期死亡率为16.7%。1年、2年和5年生存率分别为83.3%、76.7%和59.9%。
尽管肝再次移植围手术期发病率较高，但其生存结果与全球肝移植系列相似。
