An Analysis of Outcomes of Liver Retransplant in Adults: 12-Year's Single-Center Experience

Objectives: Liver retransplant is the only therapeutic option for irreversible liver graft failure. Its incidence varies between 5% and 22% worldwide. Liver retransplant - despite some recent improvement - is associated with significantly poorer outcome compared with the primary transplant. The purpose of this study was to assess the outcome of liver retransplant compared with primary liver transplant, compare the outcome of early and late liver retransplant, and to evaluate the outcome of liver retransplant within different predictive index categories. Materials and Methods: We retrospectively reviewed adult patients who had liver retransplant from May 2001 to December 2013. Patients were divided into 2 groups: group A (early liver retransplant), retransplant within 30 days; and group B (late liver retransplant), retransplant > 30 days after primary liver transplant. Results: After 460 primary adult liver transplants, 17 liver retransplants (3.7%) were performed in 16 adults. Mean patient survival after liver retransplant was 29.5 +/- 31.9 months. The 1-, 3-, and 5-year patient survival was 68.8%, 51.6%, and 38.7%. Mean graft survival following liver retransplant was 27.9 +/- 32.1 months, and 1-, 3-, and 5-year graft survival was 51.5%, 34.3%, and 22.9%. Patient and graft survival was significantly better in group B than group A at 1 year and 3 years. There were 9 liver retransplants (52.9%) with predictive index category IV; 7 retransplants (41.2%) with predictive index category III; and 1 retransplant (5.9%) with predictive index category II. Patient survival was significantly higher for predictive index category III than IV at 1 year and 3 years. Conclusions: Patient and graft survival are lower after liver retransplant than primary liver transplant. Graft and patient survival are better in late than early liver retransplant and in predictive index category III than IV.