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] Long-term survival after simultaneous pancreas-kidney transplantation with primary function of at least one year - a single-center experience
    Schulz, Tim
    Pries, Alexandra
    Caliebe, Amke
    Kapischke, Matthias
    ANNALS OF TRANSPLANTATION, 2014, 19 : 106 - 111
  • [12] Short- and long-term outcomes of 1000 adult lung transplant recipients at a single center
    Kreisel, Daniel
    Krupnick, Alexander S.
    Puri, Varun
    Guthrie, Tracey J.
    Trulock, Elbert P.
    Meyers, Bryan F.
    Patterson, G. Alexander
    JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2011, 141 (01): : 215 - 222
  • [13] Long-term survival after hepatic resection for colorectal liver metastases: a single-center study in Iran
    Pourfaraji, Seyed Morteza
    Moghadam, Mehdi Nazari
    Moradi, Ali Mohammad
    Shirmard, Fatemeh Ojaghi
    Mohammadzadeh, Narjes
    Jafarian, Ali
    BMC SURGERY, 2024, 24 (01)
  • [14] Long-term survival outcomes of duodenal adenocarcinoma: A cohort study with 15-year single-center experience
    Xie, Qing-Feng
    Long, Lian-Sheng
    Luo, Yang-Yang
    Lu, Meng-Ting
    Ming, Wai-Kit
    Zhao, Li-Ying
    Liu, Hao
    WORLD JOURNAL OF GASTROINTESTINAL SURGERY, 2025, 17 (02):
  • [15] An Overview of the Long-term Follow-up of the Adult Post-kidney Transplant Recipients in Sudan: A Single-Center Experience
    Shigidi, Mazin M. T.
    Ebrahim, Sahar A. M.
    Albashir, Sara O. M.
    SAUDI JOURNAL OF KIDNEY DISEASES AND TRANSPLANTATION, 2021, 32 (04) : 1065 - 1072
  • [16] Eurotransplant donor-risk-index and recipient factors: influence on long-term outcome after liver transplantation - A large single-center experience
    Schoening, Wenzel
    Helbig, Michael
    Buescher, Niklas
    Andreou, Andreas
    Schmitz, Volker
    Bahra, Marcus
    Puhl, Gero
    Pascher, Andreas
    Pratschke, Johann
    Seehofer, Daniel
    CLINICAL TRANSPLANTATION, 2016, 30 (05) : 508 - 517
  • [17] Donor Risk Index and MELD Interactions in Predicting Long-Term Graft Survival: A Single-Centre Experience
    Bonney, Glenn K.
    Aldersley, Mark A.
    Asthana, Sonal
    Toogood, Giles J.
    Pollard, Stephen G.
    Lodge, J. Peter A.
    Prasad, K. Rajendra
    TRANSPLANTATION, 2009, 87 (12) : 1858 - 1863
  • [18] Potential for cure and predictors of long-term survival after radiofrequency ablation for colorectal liver metastases: A 20-years single-center experience
    Weilert, Hauke
    Sadeghi, Darja
    Lipp, Michael
    Oldhafer, Karl Juergen
    Donati, Marcello
    Stang, Axel
    EJSO, 2022, 48 (12): : 2487 - 2494
  • [19] Long-term renal function and hypertension in adult survivors of childhood sarcoma: Single center experience
    Schiavetti, Amalia
    Pedetti, Valeria
    Varrasso, Giulia
    Marrucci, Oriana
    Celani, Camilla
    Andreoli, Gianmarco
    Bonci, Enea
    PEDIATRIC HEMATOLOGY AND ONCOLOGY, 2018, 35 (03) : 167 - 176
  • [20] Sarcopenia defined by psoas muscle index independently predicts long-term survival after living donor liver transplantation in male recipients
    Tan, Yifei
    Duan, Ting
    Li, Bo
    Zhang, Bohan
    Zhu, Yunfeng
    Yan, Ke
    Song, Jiulin
    Lv, Tao
    Yang, Jian
    Jiang, Li
    Yang, Jiayin
    Wen, Tianfu
    Yan, Lunan
    QUANTITATIVE IMAGING IN MEDICINE AND SURGERY, 2022, 12 (01) : 215 - +