Excellent Contemporary Graft Survival for Adult Liver Retransplantation: An Australian and New Zealand Registry Analysis From 1986 to 2017.
Journal
Transplantation direct
ISSN: 2373-8731
Titre abrégé: Transplant Direct
Pays: United States
ID NLM: 101651609
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
15
05
2019
accepted:
31
05
2019
entrez:
3
10
2019
pubmed:
3
10
2019
medline:
3
10
2019
Statut:
epublish
Résumé
Liver retransplantation is technically challenging, and historical outcomes are significantly worse than for first transplantations. This study aimed to assess graft and patient survival in all Australian and New Zealand liver transplantation units. A retrospective cohort analysis was performed using data from the Australia and New Zealand Liver Transplant Registry. Graft and patient survival were analyzed according to era. Cox regression was used to determine recipient, donor, or intraoperative variables associated with outcomes. Between 1986 and 2017, Australia and New Zealand performed 4514 adult liver transplants, 302 (6.7%) of which were retransplantations (278 with 2, 22 with 3, 2 with 4). The main causes of graft failure were hepatic artery or portal vein thrombosis (29%), disease recurrence (21%), and graft nonfunction (15%). Patients retransplanted after 2000 had a graft survival of 85% at 1 year, 75% at 5 years, and 64% at 10 years. Patient survival was 89%, 81%, and 74%, respectively. This was higher than retransplantations before 2000 ( Australia and New Zealand have excellent survival following liver retransplantation. These contemporary results should be utilized for transplant waitlist methods.
Sections du résumé
BACKGROUND
BACKGROUND
Liver retransplantation is technically challenging, and historical outcomes are significantly worse than for first transplantations. This study aimed to assess graft and patient survival in all Australian and New Zealand liver transplantation units.
METHODS
METHODS
A retrospective cohort analysis was performed using data from the Australia and New Zealand Liver Transplant Registry. Graft and patient survival were analyzed according to era. Cox regression was used to determine recipient, donor, or intraoperative variables associated with outcomes.
RESULTS
RESULTS
Between 1986 and 2017, Australia and New Zealand performed 4514 adult liver transplants, 302 (6.7%) of which were retransplantations (278 with 2, 22 with 3, 2 with 4). The main causes of graft failure were hepatic artery or portal vein thrombosis (29%), disease recurrence (21%), and graft nonfunction (15%). Patients retransplanted after 2000 had a graft survival of 85% at 1 year, 75% at 5 years, and 64% at 10 years. Patient survival was 89%, 81%, and 74%, respectively. This was higher than retransplantations before 2000 (
CONCLUSIONS
CONCLUSIONS
Australia and New Zealand have excellent survival following liver retransplantation. These contemporary results should be utilized for transplant waitlist methods.
Identifiants
pubmed: 31576368
doi: 10.1097/TXD.0000000000000920
pmc: PMC6708636
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e472Informations de copyright
Copyright © 2019 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors declare no funding or conflicts of interest.
Références
HPB (Oxford). 2010 Apr;12(3):217-24
pubmed: 20590890
Transplant Proc. 1991 Dec;23(6):3029-31
pubmed: 1721349
Heart Lung Circ. 2015 Jul;24(7):633-4
pubmed: 25766662
Clin Liver Dis. 2017 May;21(2):435-447
pubmed: 28364823
Am J Transplant. 2018 Jan;18 Suppl 1:172-253
pubmed: 29292603
Ann Surg. 1997 Oct;226(4):408-18; discussion 418-20
pubmed: 9351709
Liver Transpl. 2007 Feb;13(2):248-57
pubmed: 17205553
Transplant Proc. 2004 Apr;36(3):525-6
pubmed: 15110580
Hepatology. 1999 Feb;29(2):365-70
pubmed: 9918911
JAMA. 1993 Nov 24;270(20):2469-74
pubmed: 8230624
Clin Liver Dis. 2014 Aug;18(3):731-51
pubmed: 25017086
N Engl J Med. 1994 Oct 27;331(17):1110-5
pubmed: 7523946
BMC Med Ethics. 2012 May 24;13:11
pubmed: 22624597
Am J Transplant. 2014 May;14(5):1120-8
pubmed: 24731165
Am J Transplant. 2008 Feb;8(2):404-11
pubmed: 18211509