Predictive Index for Long-Term Survival After Retransplantation of the Liver in Adult Recipients Analysis of a 26-Year Experience in a Single Center

被引:65
|
作者
Hong, Johnny C. [1 ]
Kaldas, Fady M.
Kositamongkol, Prawat
Petrowsky, Henrik
Farmer, Douglas G.
Markovic, Daniela [2 ]
Hiatt, Jonathan R.
Busuttil, Ronald W.
机构
[1] Univ Calif Los Angeles, Div Liver & Pancreas Transplantat, Dumont UCLA Transplant & Liver Canc Ctr, Pfleger Liver Inst,David Geffen Sch Med,Dept Surg, Los Angeles, CA 90095 USA
[2] Univ Calif Los Angeles, David Geffen Sch Med, Dept Biomath, Los Angeles, CA 90095 USA
关键词
SINGLE-CENTER; GRAFT FAILURE; UNITED-STATES; TRANSPLANTATION; EXPERIENCE; MODEL; OUTCOMES;
D O I
10.1097/SLA.0b013e31822c5878
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective: To develop a prognostic scoring system for risk stratification of patients with hepatic graft failure (GF) undergoing retransplants of the liver (ReLT) and improve patient selection. Summary of Background Data: Retransplantation of the liver remains controversial because of inferior outcomes compared with the primary orthotopic liver transplantation (OLT) and raises concerns of inappropriate utilization of a scarce donor organ resource. Data on risk stratification of ReLT patients for long-term survival outcomes are limited. Methods: We conducted an analysis from our prospective database of 466 adults' ReLT between February 1984 and September 2010. Mean follow-up was 3 years. Each independent predictor for allograft failure was assigned risk score (RS) points of 1 or 2, proportional to the corresponding parameter estimate under the Cox model: Predictive index category (PIC) 1, RS = 0; PIC II, RS = 1 to 2; PIC III, RS = 3 to 4; and PIC IV, RS = 5 to 12. Results: Eight risk factors predictive for GF after ReLT included recipient age greater than 55 years, Model for End-Stage Liver Disease score greater than 27, history of prior OLT greater than 1, pre-ReLT requirement for mechanical ventilation, serum albumin less than 2.5 g/dL, donor age greater than 45 years, intraoperative requirement of packed red blood cell transfusion greater than 30 units, and performance of ReLT between 15 and 180 days from the prior OLT. Five-year GF-free survival was significantly higher in PIC I (65%) than in PIC II (53%), PIC III (43%), and PIC IV (20%) groups (P < 0.001). Conclusions: This risk-stratification model was highly predictive of long-term outcome after liver retransplantation in adult recipients. This formula provides a practical guide for selection of candidates for retransplantation of the liver that can lead to improved patient outcomes and optimal utilization of a scarce resource.
引用
收藏
页码:444 / 449
页数:6
相关论文
共 50 条
  • [11] Liver retransplantation in adult recipients: analysis of a 38-year experience in the Netherlands
    Takagi, Kosei
    Domagala, Piotr
    Porte, Robert J.
    Alwayn, Ian
    Metselaar, Herold J.
    van den Berg, Aad P.
    van Hoek, Bart
    Ijzermans, Jan N. M.
    Polak, Wojciech G.
    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES, 2020, 27 (01) : 26 - 33
  • [12] Long-term survival and late graft loss in pediatric liver transplant recipients -: A 15-year single-center experience
    Wallot, MA
    Mathot, M
    Janssen, M
    Hölter, T
    Paul, K
    Buts, JP
    Reding, R
    Otte, JB
    Sokal, EM
    LIVER TRANSPLANTATION, 2002, 8 (07) : 615 - 622
  • [13] Comparison of short-and long-term outcomes after early versus late liver retransplantation: a single-center experience
    Kamei, Hideya
    Al-Basheer, Mamoun
    Shum, Jeffrey
    Bloch, Michael
    Wall, William
    Quan, Douglas
    JOURNAL OF SURGICAL RESEARCH, 2013, 185 (02) : 877 - 882
  • [14] FEATURES OF A VERY LONG-TERM SURVIVAL AFTER LIVER TRANSPLANTATION IN ITALY: A PRELIMINARY SINGLE CENTER EXPERIENCE
    Donato, Maria
    Dibenedetto, Clara
    Sguazzini, Enrico
    Sagasta, Michele
    Antonelli, Barbara
    Farina, Elisa
    Invernizzi, Federica
    Caccamo, Lucio
    de Feo, Tullia Maria
    Lampertico, Pietro
    HEPATOLOGY, 2024, 80 : S1041 - S1042
  • [15] Long-Term Results of 81 Prevertebral Subclavian Artery Angioplasties: A 26-Year Experience
    Berger, Ludovic
    Bouziane, Zacharie
    Felisaz, Aurelien
    Coffin, Olivier
    Dugue, Audrey
    Maiza, Dominique
    ANNALS OF VASCULAR SURGERY, 2011, 25 (08) : 1043 - 1049
  • [16] Predictive factors for long-term survival after hepatic resection for hepatocellular carcinoma: a single-center experience
    Said, Rami
    Farouk, Ahmed
    Sultan, Ahmad M.
    Elshobary, Mohamed
    Shehta, Ahmed
    EGYPTIAN JOURNAL OF SURGERY, 2021, 40 (01): : 22 - 30
  • [17] Impact of Basiliximab Induction in Adult Recipient Survival at 60 Months after Liver Retransplantation Procedure: Single Center Experience
    Pagano, Duilo
    Panarello, Giovanna
    Tuzzolino, Fabio
    Barbara, Marco
    Cintorino, Davide
    Tropea, Alessandro
    Luca, Angelo
    Gruttadauria, Salvatore
    TRANSPLANTATION, 2018, 102 : S908 - S908
  • [18] Long-term survival in visceral transplant recipients in the new era: A single-center experience
    Elsabbagh, Ahmed M.
    Hawksworth, Jason
    Khan, Khalid M.
    Kaufman, Stuart S.
    Yazigi, Nada A.
    Kroemer, Alexander
    Smith, Coleman
    Fishbein, Thomas M.
    Matsumoto, Cal S.
    AMERICAN JOURNAL OF TRANSPLANTATION, 2019, 19 (07) : 2077 - 2091
  • [19] Adjuvant Pelvic Radiation Improves Survival for Patients With Uterine Carcinosarcoma: A 26-Year Single Center Experience
    Dhanireddy, B.
    Johnson, M. S.
    Mogni, B.
    Mannan, F.
    Shelton, B. J.
    Feddock, J. M.
    Desimone, C. P.
    Ueland, F.
    Randall, M. E.
    INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2017, 99 (02): : E289 - E289
  • [20] Long-Term Outcome of the First 150 Liver Transplant Recipients: A Single-Center Experience
    Sintra, S. N.
    Tome, L.
    Cipriano, M. A.
    Bento, C.
    Furtado, E.
    TRANSPLANTATION PROCEEDINGS, 2013, 45 (03) : 1119 - 1121