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When shouldn't we retransplant? Liver Transpl 2005 Nov(11 Suppl 2):S14-20

Date

10/21/2005

Pubmed ID

16237729

DOI

10.1002/lt.20599

Scopus ID

2-s2.0-30444440058   54 Citations

Abstract

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 RM

Author

Michael A. Zimmerman MD, FACS Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Graft Rejection
Humans
Liver Failure
Liver Transplantation
Prognosis
Reoperation
jenkins-FCD Prod-486 e3098984f26de787f5ecab75090d0a28e7f4f7c0