![]() Model for End-Stage Liver Disease (MELD) scores were not predictive of survival from reTX. ![]() The 1-yr and 3-yr survival rates after reTX were also similar for HCV reTX and non-HCV reTX groups (1 yr, 69% vs. Duration of hospitalization, number of intensive care unit (ICU) days, and time interval from listing to transplantation or reTX were similar between reTX groups. The commonest indications for non-HCV reTX were chronic rejection (36%), hepatic artery thrombosis (31%) and recurrent primary sclerosing cholangitis (17%). They were predominantly male, Caucasian, with mean age of 47.2 yr. Patients were divided into 3 groups group 1: HCV reTX (n = 43), group 2: non-HCV reTX (n = 73), and group 3: recurrent HCV but no reTX (n = 156). study group was formed to retrospectively compare survival after reTX in patients with recurrent HCV (histologically proven) and those transplanted for other indications greater than 90 days after first transplantation, from 1996 to 2004. Transplant centers debate the utility of offering another liver to these patients. It is widely perceived that outcomes are relatively poor following retransplantation (reTX) for recurrent of hepatitis C virus (HCV) infection. Cases with primary graft nonfunction displayed lower survival, because of their compromised clinical status as evidenced by their high MELD scores. 05).Ī MELD score of 25 is a valid cut-off to predict the outcome of retransplantations, it may be useful to select patients among those who require a second graft. 05) and higher mean MELD score (30.7 vs 21.9, P <. Patients retransplanted for primary graft nonfunction showed significant lower 5-year survival rates than those for other indications (28.6% vs 54.5%, P <. During the first 30 postoperative days, patients with a MELD higher than 25 lost the second graft in 48% of cases compared to 16% in the other group (P <. A MELD score of 25, calculated by ROC curves, significantly predicted graft and patient survival (44.2% vs 22.5%, P <. Overall patient survivals at 1, 3, and 5 years were 62.4%, 50.7%, and 49.1%, respectively. Indications for retransplantation were: 38 (43.7%) surgical complications 12 (13.8%) chronic rejections 15 (17.2%) disease recurrences and 22 (15.3%) primary graft nonfunction. In addition to graft and patient survivals, ROC curves were used to establish the best MELD score to select cases with poor outcomes. The graft outcomes in patients with high MELD scores and the presence of hepatitis C were found to be particularly poor.We retrospectively investigated the efficacy of the MELD score to predict the outcome of liver retransplantation and serve as selection criteria.įrom 1987 to 2003, the 765 liver transplantations included 87 patients (11.4%) who received a second graft. Among the patients with high MELD scores, those with hepatitis C and LDLT in Era-I had the worst 5-year graft survival rate (14.3, p < 0.001). The 5-year graft survival rate was significantly lower in patients in Era-I (n = 119) compared with those in Era-II/III when stratified by low (73.0 vs. ![]() Among patients with hepatitis C (n = 155), the 5-year graft survival rate was significantly lower in patients with high MELD scores (33.7 %, p < 0.001) than in patients with low MELD scores. However, among patients with high MELD scores, a multivariate analysis showed that the presence of hepatitis C (p = 0.013) and LDLT in Era-I (p = 0.036) was significantly associated with a poorer prognosis. ![]() Overall, 46 patients had high MELD scores (≥ 25) and their graft survival was similar to that in patients with low MELD scores (<25 n = 311 p = 0.395). The feasibility of performing living donor liver transplantation (LDLT) for patients with high end-stage liver disease (MELD) scores needs to be assessed.Ī total of 357 patients who underwent LDLT were included in this analysis. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |