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Title: Excellent Contemporary Graft Survival for Adult Liver Retransplantation: An Australian and New Zealand Registry Analysis From 1986 to 2017.
Austin Authors: Jeffrey, Angus W;Delriviere, Luc;McCaughan, Geoff;Crawford, Michael;Angus, Peter W ;Jones, Robert M ;Macdonald, Graeme A;Fawcett, Jonathan;Wigg, Alan;Chen, John;Gane, Ed;Munn, Stephen;Jeffrey, Gary P
Affiliation: Department of Gastroenterology and Hepatology, Auckland City Hospital, New Zealand
Translational Research Institute, Brisbane, Queensland
School of Medicine, The University of Queensland, Brisbane, Queensland
Department of Gastroenterology and Hepatology, Sir Charles Gairdner Hospital, Perth, Australia
School of Medicine, University of Western Australia, Nedlands, Australia
Department of Gastroenterology and Hepatology, Flinders Medical Centre, Adelaide, Australia
Department of Gastroenterology and Hepatology, Princess Alexandria Hospital, Brisbane, Australia
Department of Gastroenterology, Austin Health, Heidelberg, Victoria, Australia
Department of Gastroenterology and Hepatology, Royal Prince Alfred Hospital, Sydney, Australia
School of Medicine, University of Sydney, Sydney, Australia
Centenary Research Institute, Sydney, Australia
Issue Date: Aug-2019 2019-07-23
Publication information: Transplantation direct 2019; 5(8): e472
Abstract: 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 (P < 0.001). Univariate analysis found that increased recipient age (P = 0.001), recipient weight (P = 0.019), and donor age (P = 0.011) were associated with decreased graft survival prior to 2000; however, only increased patient weight was significant after 2000 (P = 0.041). Multivariate analysis found only increased recipient weight (P = 0.042) and donor age (P = 0.025) was significant prior to 2000. There was no difference in survival for second and third retransplants or comparing time to retransplant. Australia and New Zealand have excellent survival following liver retransplantation. These contemporary results should be utilized for transplant waitlist methods.
DOI: 10.1097/TXD.0000000000000920
PubMed URL: 31576368
ISSN: 2373-8731
Type: Journal Article
Appears in Collections:Journal articles

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