Initial graft function following liver transplantation is a major determinant of postoperative survival and morbidity.
Primary graft nonfunction is uncommon; however, it is one of the most serious and life-threatening conditions in the immediate postoperative period.
The risk factors associated with primary graft nonfunction and short-term outcome have been previously reported.
However, there are no reports of long-term follow-up after retransplant for primary graft nonfunction.
Dr Goran Klintmalm and colleagues from Seattle assessed Primary graft nonfunction after retransplant.
|Hospital mortality was 57% with retransplants|
The research team found that 52 liver transplants had primary graft nonfunction among 2341 orthotopic liver transplants in 2130 patients from 1984 to 2003.
The team noted that primary graft nonfunction occurred more often in the retransplant setting.
Female donors, donor age, donor days in the intensive care unit, cold ischemia time were significant factors for primary graft nonfunction.
The researchers observed that operating room time was a significant factor for primary graft nonfunction.
Patient as well as graft survival of retransplant for primary graft nonfunction was not different compared to retransplant for other causes.
The researchers observed that primary graft nonfunction for a second or third transplant did not demonstrate long-term survival.
The research team found that hospital mortality was 57% with retransplants.
Dr Klintmalm's team concludes, “Retransplant for primary graft nonfunction in the initial transplant can achieve relatively good long-term survival.”
“However, if another transplant is needed in the setting of a second primary graft nonfunction, the third retransplant should probably not be done due to poor expected outcome.”