Context: Five percent of liver transplant recipients require retransplantation within the first year. In light of the critical donor shortage, a critical analysis of risk factors for retransplantation is necessary to reduce this rate.
Objective: The objective was to examine the retransplantation rates at differing time periods following liver transplantation to isolate high-risk periods. A further objective was to compare risk factors for retransplantation at these high-risk time periods.
Methods: We performed a retrospective analysis of UNOS de-identified patient-level data of adult liver transplant recipients between January 1, 2002 and October 31, 2011. We analyzed 49,288 recipients. The primary outcome measure was retransplantation at 7 days, 30 days, and 365 days following liver transplantation. Multivariate logistic regression (stepwise backward) was performed.
Results: The highest retransplantation rate was during the first week (1.0%). The first month had the highest retransplantation rate by month (2.3%). The first year had the highest mortality rate by year (5.4%). Figure 1 and 2 report the significant donor and recipient risk factors for 1 day, 1 month, and 1 year mortality. The strongest risk factors for retransplantation within one day was cold ischemia time over 16 hours (OR 3.6 CI 2.4-5.5); within 1 month was split donor allograft (OR 2.9 CI 1.2-7.1); and within 1 year was donation after cardiac death (OR 4.9 CI 3.6-6.6).
Conclusion: The high-risk periods for retransplantation are during the first week, first month, and first year following liver transplantation. Each high-risk period has common and distinct risk factors for retransplantation. Prolonged cold ishemia time, split donor allograft, and donation after cardiac death were prominent risk factors.
To cite this abstract in AMA style:Rana A, Porubsky M, Jie T, Habib S, Rilo H, Kaplan B, Gruessner A, Gruessner R. Critical Analysis of Retransplantation within 1 Year after Liver Transplantation, A [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/critical-analysis-of-retransplantation-within-1-year-after-liver-transplantation-a/. Accessed July 24, 2021.
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