Analysis of indications and causes of death in liver retransplantation

Objective To evaluate the indications and causes of death of liver retransplantation. Methods Clinical data of 36 patients underwent liver retransplantation in Liver Transplantation Center of Third Affiliated Hospital of Sun Yat-sen University from September 2003 to July 2009 were analyzed retrospectively. Results The incidence of liver retransplantation was 4.7 % in the center during the same period. Biliary tract complications (53 %)were the main cause for liver retransplantation. Other common causes were vascular complications (22 %) and recurrence of primary diseases(22 %). All the patients received modified piggyback liver transplantation with cavaplasty. No perioperative mortality occurred. Postoperative death occurred in 18 cases. Seven cases died of severe infection. Four cases died of renal failure and multiple organ failure and 4 cases died of recurrence of hepatocellular carcinoma. Another 3 cases respectively died of myocardial infarction, intracranial hemorrhage and vascular complications. The other 18 patients were still alive with satisfactory graft function. The follow-up time was from 24 to 81 months with the median survival time of 54.5 months. One and three-year survival rates after liver retransplantation were 61 % and 44 %. Conclusion Bile duct complication after liver transplantation is the main indication for liver retransplantation. One and three-year survival rates after liver retransplantation are low and infection disease is the main cause of death in liver retransplantation.