*Purpose: There are no published studies to compare long-term outcomes of retrograde-reperfusion-technique (RR) compared to antegrade-reperfusion-technique (AR) in liver-transplantation (LT). This retrospective-cohort-study compares short/long-term outcomes of RR with standard method of AR.

*Methods: All cadaveric whole-LT-cases performed between 2003 and 2005 were reviewed. 175-patients received their first LT within the specified-period (N=133 with AR & N= 42 with RR). 2:1 matched-pairs based on the propensity-score-(PS) (N=69 AR& N=32 RR-patients) for survival-analyses were estimated by logistic-regression with calliper of 20% of SD after controlling for donor/recipient age at transplantation, hospital-stay, cold-ischemia-time and IVC-clamp-release-time . Survival-estimation was done by multivariate/Cox-regression-models.

*Results: There was no statistical-difference in graft/patient survival at 1, 3, 5 & 10-year-period in either group (Fig-1). No significant-differences were detected between the two groups with regards to age of the donor, recipient gender and rejection rates. RR-group had Superior IVC-clamp off time, cold-ischemia-time, total-hospital-stay post-LT , serum-creatinine, bilirubin, INR and ALT at day 1, 7, and 14 compared to AR-group (Table-1). Biliary-complication-rate of AR-group was 8/133 (6%) patients vs 1/42 (2.4%) patients in RR-group (p<0.68). 07/133 patient from the AR-group required a stent. 2/8 AR; 1/1 RR-patients subsequently had ischemic-type biliary lesion-(ITBL) requiring transplantation in either groups

*Conclusions: RR and AR-cohorts have similar long-term outcomes; RR provides superior early-graft-function and aids early hospital-discharge.

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