Short and Long Term Outcomes of Retrograde vs Antegrade Reperfusion of Liver Transplants. A Propensity Matched Pair Analysis

H. Sharma, B. Shrum, D. Quan, A. Skaro, W. Wall, V. McAlister.

Transplant Surgery, University of Western Ontario, London, ON, Canada

Meeting: 2019 American Transplant Congress

Abstract number: C355

Keywords: Liver transplantation, Survival

Session Information

Session Name: Poster Session C: Surgical Issues: All Organs

Session Type: Poster Session

Date: Monday, June 3, 2019

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall C & D

*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.

To cite this abstract in AMA style:

Sharma H, Shrum B, Quan D, Skaro A, Wall W, McAlister V. Short and Long Term Outcomes of Retrograde vs Antegrade Reperfusion of Liver Transplants. A Propensity Matched Pair Analysis [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/short-and-long-term-outcomes-of-retrograde-vs-antegrade-reperfusion-of-liver-transplants-a-propensity-matched-pair-analysis/. Accessed November 21, 2024.

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