PO-097 : Clinical Outcomes of Re-Transplantation: A Single-Center Experience

Aims: Re-transplantation is the only therapeutic option for irreversible graft failure. The aim of this study is to analyze a single center’s experience of the outcome of liver re-transplantation and reviewed the technical feasibility and possibility of living donor re-transplantation as another option of re-transplantation. Methods: All patients who underwent LT twice or more at Asan Medical Center between February 1994 and December 2014 were included. Total 4428 liver transplantation (living donor liver transplantation (LDLT) 3743 cases, deceased donor liver transplantation (DDLT) 685 cases) were performed at our institute. To compare clinical outcomes including graft and patient survival rate, we defined the patients who underwent LT once during same period as control group. Results: Among 4428 cases of total LT cases during the study period, adult LT were 4196 cases and pediatric LT were 232 cases. 146 cases (3.3%) were performed as re-LT. Adult re-LT were 126 cases (86.3%) and pediatric re-LT were 20 cases (13.7%). The mean age of 146 recipients of re-LT was 41.5±17.2 (1.2~68) years old. 98 patients (67.1%) were male and 48 (32.9%) were female. The overall 1-, 3-, 5- and 10-year survival rates following primary LT were 91.6%, 83.9%, 82.2%, 78.2% respectively. And the overall 1-, 3-, 5- and 10-year survival rates following re-LT were 68.3%, 61.2%, 58.5%, 58.5%. In multivariate analysis, MELD>20 (P=0.000), ventilator support (P=0.023), Age>16 (P=0.000), bacteremia (P=0.032) and pneumonia (P=0.021) reached statistical significance which affecting the survival rate of re-LT patients. Conclusions: Overall survival of re-transplantation patients has improved in recent years. If we could overcome the technical issues and medical problems in these patients, living donor re-transplantation would be another option for shortening the waiting period of cadaveric donor and consequently preventing deterioration of medical problem in recipients.