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Article: Comparable short- and long-term outcomes in deceased-donor and living-donor liver retransplantation

TitleComparable short- and long-term outcomes in deceased-donor and living-donor liver retransplantation
Authors
KeywordsBiliary complications
Deceased-donor liver re-transplantation
Graft failure
Hepatic artery thrombosis
Living-donor liver re-transplantation
Issue Date2017
PublisherSpringer New York LLC. The Journal's web site is located at http://www.springer.com/west/home/medicine?SGWID=4-10054-70-173733513-0
Citation
Hepatology International, 2017, v. 11 n. 6, p. 517-522 How to Cite?
AbstractBackground and purpose: There is a big controversy over liver retransplantation, the only life-saving treatment for patients with a failing or failed liver graft. This retrospective study tried to determine if living-donor liver retransplantation (re-LDLT) is a justifiable alternative to deceased-donor liver retransplantation (re-DDLT). Methods: Anonymous data of liver transplant patients from January 2000 to April 2016 were reviewed. Recipients of retransplantation were divided into the re-DDLT and re-LDLT groups. The groups were compared in demographic characteristics, pre-retransplant and intraoperative details, and short- and long-term outcomes. Risk for living donors was examined. Results: Twenty-nine patients had 33 re-DDLTs and 15 patients received re-LDLT. The re-LDLT group had lighter grafts (525 vs. 1295 g, p ≤ 0.001), a smaller ratio of graft weight to recipient standard liver volume (56.98 vs. 107.7%, p ≤ 0.001), and shorter cold ischemia (106 vs. 451 min, p ≤ 0.001). The groups were otherwise comparable. Two patients in the re-DDLT group had Grade-5 complication. The groups were similar in patient survival (p = 0.326) and graft survival (p = 0.102). No living donors died, but three of them developed Grade-1 complications. Conclusion: With the required expertise, re-LDLT can produce results comparable to those of re-DDLT while keeping donor risk at bay. In places where the demand for deceased-donor liver grafts far outstrips supply, re-LDLT can be considered as an alternative to re-DDLT if the expertise is available and if the potential recipient benefits can balance out the potential donor risks.
Persistent Identifierhttp://hdl.handle.net/10722/259379
ISSN
2017 Impact Factor: 4.117
2015 SCImago Journal Rankings: 0.669
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChok, KSH-
dc.contributor.authorChan, ACY-
dc.contributor.authorFung, JYY-
dc.contributor.authorDai, WC-
dc.contributor.authorCheung, TT-
dc.contributor.authorLo, CM-
dc.date.accessioned2018-09-03T04:06:27Z-
dc.date.available2018-09-03T04:06:27Z-
dc.date.issued2017-
dc.identifier.citationHepatology International, 2017, v. 11 n. 6, p. 517-522-
dc.identifier.issn1936-0533-
dc.identifier.urihttp://hdl.handle.net/10722/259379-
dc.description.abstractBackground and purpose: There is a big controversy over liver retransplantation, the only life-saving treatment for patients with a failing or failed liver graft. This retrospective study tried to determine if living-donor liver retransplantation (re-LDLT) is a justifiable alternative to deceased-donor liver retransplantation (re-DDLT). Methods: Anonymous data of liver transplant patients from January 2000 to April 2016 were reviewed. Recipients of retransplantation were divided into the re-DDLT and re-LDLT groups. The groups were compared in demographic characteristics, pre-retransplant and intraoperative details, and short- and long-term outcomes. Risk for living donors was examined. Results: Twenty-nine patients had 33 re-DDLTs and 15 patients received re-LDLT. The re-LDLT group had lighter grafts (525 vs. 1295 g, p ≤ 0.001), a smaller ratio of graft weight to recipient standard liver volume (56.98 vs. 107.7%, p ≤ 0.001), and shorter cold ischemia (106 vs. 451 min, p ≤ 0.001). The groups were otherwise comparable. Two patients in the re-DDLT group had Grade-5 complication. The groups were similar in patient survival (p = 0.326) and graft survival (p = 0.102). No living donors died, but three of them developed Grade-1 complications. Conclusion: With the required expertise, re-LDLT can produce results comparable to those of re-DDLT while keeping donor risk at bay. In places where the demand for deceased-donor liver grafts far outstrips supply, re-LDLT can be considered as an alternative to re-DDLT if the expertise is available and if the potential recipient benefits can balance out the potential donor risks.-
dc.languageeng-
dc.publisherSpringer New York LLC. The Journal's web site is located at http://www.springer.com/west/home/medicine?SGWID=4-10054-70-173733513-0-
dc.relation.ispartofHepatology International-
dc.rightsThe final publication is available at Springer via http://dx.doi.org/[insert DOI]-
dc.subjectBiliary complications-
dc.subjectDeceased-donor liver re-transplantation-
dc.subjectGraft failure-
dc.subjectHepatic artery thrombosis-
dc.subjectLiving-donor liver re-transplantation-
dc.titleComparable short- and long-term outcomes in deceased-donor and living-donor liver retransplantation-
dc.typeArticle-
dc.identifier.emailChok, KSH: chok6275@hku.hk-
dc.identifier.emailChan, ACY: acchan@hku.hk-
dc.identifier.emailFung, JYY: jfung@hkucc.hku.hk-
dc.identifier.emailDai, WC: daiwc@HKUCC-COM.hku.hk-
dc.identifier.emailCheung, TT: cheung68@hku.hk-
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hk-
dc.identifier.authorityChok, KSH=rp02110-
dc.identifier.authorityChan, ACY=rp00310-
dc.identifier.authorityFung, JYY=rp00518-
dc.identifier.authorityCheung, TT=rp02129-
dc.identifier.authorityLo, CM=rp00412-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s12072-017-9821-2-
dc.identifier.scopuseid_2-s2.0-85029716129-
dc.identifier.hkuros288607-
dc.identifier.volume11-
dc.identifier.issue6-
dc.identifier.spage517-
dc.identifier.epage522-
dc.identifier.isiWOS:000416341100007-
dc.publisher.placeUnited States-

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