Because of the worse results from retransplantation in relation to the initial liver transplantation, there is a need to refine the indication for retransplantation.
Dr Marcelo Linhares and colleagues studied 139 patients who underwent liver retransplantation.
The investigative team studied 30 variables, of which 18 related to the recipient, and 12 to the donor.
All the independent variables were initially compared with the length of survival using univariate analyses.
The investigators then compared variables presenting significance with the dependent variable of length of survival.
The team determined which factors were related to longer survival among patients, when evaluated together.
Multivariate model for determining long-term survival among patients with retransplants was used.
|5-year survival for the lowest percentile distributions was 77% vs 21% in the upper percentile|
The model was built up using variables such as the recipient's age, creatinine, urgency of retransplantation, and early failure of the first graft.
Through this multivariate model, the investigators were able to determine a score that was categorized according to tertile distributions.
The investigative team allocated distributions below the 33rd percentile a score of less than 24.
The 33rd to 66th percentile were scored from 24 to 32, while distributions above the 66th percentile scored above 32.
The 1 year, 3-year, and 5-year patient survival rates following retransplantation were respectively 85%, 82%, and 77% for scores below 24.
The team found that the respective 1-year, 3-year, and 5-year survival rates after retransplantation were 69%, 66%, and 61% for scores between 24 and 32.
Scores above 32 had 1-year, 3-year, and 5-year patient survival rates of 21%, 19%, and 16%, respectively.
Dr Linhares' team concluded, “The variables of recipient's age, creatinine, urgency of retransplantation, and early failure of the initial transplantation were factors that were independently related to the long-term survival of patients with liver retransplants.”