Hepatology research : the official journal of the Japan Society of Hepatology · 2012
Disease recurrence plays a minor role as a cause for retransplantation after living-donor liver transplantation for primary biliary cirrhosis: A multicenter study in Japan.
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Egawa Hiroto, Nakanuma Yasuni, Maehara Yoshihiko, Uemoto Shinji, Eguchi Susumu, Sato Yoshinobu, Shirabe Ken, Takatsuki Mitsuhisa, Mori Akira, Yamamoto Masakazu, Tsubouchi Hirohito
Аннотация
AIM: To clarify the role of disease recurrence as a cause of graft loss after living-donor liver transplantation (LDLT) for primary biliary cirrhosis (PBC), we investigated explant grafts, as well as the native liver and liver biopsy specimens, of patients who underwent retransplantation.
METHODS: Of 516 patients who underwent LDLT for PBC and were registered in the Japanese Liver Transplant Registry, nine patients (1.7%) underwent retransplantation.
RESULTS: Seven patients undergoing retransplantation later than 6 months after primary liver transplantation (LT) were enrolled. All seven patients were female, with ages ranging from 34-57 years, and Model for End-Stage Liver Disease scores ranging 10-28. The right lobe was used as graft in one and the left lobe in six. The initial immunosuppression regimen was tacrolimus in six and cyclosporin in one. The period between the primary LT and retransplantation ranged 11-120 months, with a median of 36 months. Three patients survived and four patients died due to poor graft functions or complications after retransplantation. The primary causes of primary graft loss revealed by histological examination of the explant livers were chronic rejection in three, portal thrombus and/or steatohepatitis in three and outflow block in one. PBC recurrence was observed in 3 and the stage was mild in all.
CONCLUSION: PBC recurrence has a small impact as a cause of graft loss after LDLT.
METHODS: Of 516 patients who underwent LDLT for PBC and were registered in the Japanese Liver Transplant Registry, nine patients (1.7%) underwent retransplantation.
RESULTS: Seven patients undergoing retransplantation later than 6 months after primary liver transplantation (LT) were enrolled. All seven patients were female, with ages ranging from 34-57 years, and Model for End-Stage Liver Disease scores ranging 10-28. The right lobe was used as graft in one and the left lobe in six. The initial immunosuppression regimen was tacrolimus in six and cyclosporin in one. The period between the primary LT and retransplantation ranged 11-120 months, with a median of 36 months. Three patients survived and four patients died due to poor graft functions or complications after retransplantation. The primary causes of primary graft loss revealed by histological examination of the explant livers were chronic rejection in three, portal thrombus and/or steatohepatitis in three and outflow block in one. PBC recurrence was observed in 3 and the stage was mild in all.
CONCLUSION: PBC recurrence has a small impact as a cause of graft loss after LDLT.