When shouldn't we retransplant? Liver Transpl 2005 Nov(11 Suppl 2):S14-20
Date
10/21/2005Pubmed ID
16237729DOI
10.1002/lt.20599Scopus ID
2-s2.0-30444440058 (requires institutional sign-in at Scopus site) 61 CitationsAbstract
1. In the setting of early graft failure after primary transplantation, orthotopic liver retransplantation (re-OLT) should be undertaken within the first 7 days, but it should be discouraged within 8-30 days, since re-OLT within this intermediate frame is associated with the worst results. 2. Late retransplantation should be cautioned in severely ill patients who exhibit Model for End-Stage Liver Disease (MELD) scores >25, require mechanical ventilation, have advanced renal insufficiency, and in advanced-age recipients. 3. Re-OLT should not be undertaken with extended and older donors particularly when retransplantation for recurrent disease is considered. 4. Prognostic models that take into account the severity of disease and the effect of the organ to be transplanted should be developed to better predict outcomes after re-OLT. 5. Accurate definitions of acceptable outcomes after retransplantation and "futile re-OLT" are desperately needed.
Author List
Zimmerman MA, Ghobrial RMMESH terms used to index this publication - Major topics in bold
Graft RejectionHumans
Liver Failure
Liver Transplantation
Prognosis
Reoperation
