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Cause and timing of first allograft failure in orthotopic liver transplantation: A study of 177 consecutive patients

Quiroga, J and Colina, I and Demetris, AJ and Starzl, TE and van Thiel, DH (1991) Cause and timing of first allograft failure in orthotopic liver transplantation: A study of 177 consecutive patients. Hepatology, 14 (6). 1054 - 1062. ISSN 0270-9139

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Abstract

The cause and timing of first liver allograft failure was evaluated in 177 patients who underwent a second liver transplant between January 1984 and December 1988. The population studied consisted of 94 men and 83 women with a mean age 41.3 ± 1.0 yr (mean ± S.E.M.). Mean first‐graft survival was 130.6 ± 22.9 days (range = 0 to 2,073 days). Sixty‐eight percent of the grafts failed in the first postoperative month, 26% failed between the second and twelfth month and only 6% failed beyond the twelfth month from the date of the initial transplant. Six principal causes of graft failure were identified. Early allograft losses occurred as a result of four major problems: primary graft nonfunction (30.0% of all grafts; mean graft survival = 3.4 ± 0.3 days); ischemic injury of the graft without overt vascular injury (9.6%; mean graft survival = 17.5 ± 1.9 days); acute rejection (10.7%; mean graft survival = 30.4 ± 6.4 days); and overt vascular complications (26.6%; mean graft survival = 59.6 ± 24.1 days). Late graft failures were the result of either chronic rejection (11.3%; mean graft survival = 496.3 ± 136.0 days) or recurrence of the primary liver disease (6.8%; mean graft survival = 550.5 ± 172.1 days). Graft failure occurred as a result of a variety of miscellaneous causes in 5% of the cases (mean graft survival in this group = 300.0 ± 110.6 days). Overall 6‐mo patient survival after a second liver transplant was 46.3%. Patients who had a retransplant because of chronic rejection and ischemic injury had the greatest (65%) and least (23%) 6‐mo survival rates respectively after second grafting (p < 0.05). Those who survived the second transplant procedure for 6 mo or more tended be younger (p < 0.01) and had a reduced first transplant requirement for red blood cells (p < 0.05), latelets (p < 0.01) and fresh frozen plasma (p < 0.01) than did those who died during the 6 mo after their second transplant procedure. (HEPATOLOGY 1991;14:1054–1062.) Copyright © 1991 American Association for the Study of Liver Diseases


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Quiroga, J
Colina, I
Demetris, AJ
Starzl, TEtes11@pitt.eduTES11
van Thiel, DH
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1991
Date Type: Publication
Journal or Publication Title: Hepatology
Volume: 14
Number: 6
Page Range: 1054 - 1062
DOI or Unique Handle: 10.1002/hep.1840140618
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0270-9139
Other ID: uls-drl:31735062112861, Starzl CV No. 1497
Date Deposited: 08 Apr 2010 17:25
Last Modified: 27 Jan 2019 02:55
URI: http://d-scholarship.pitt.edu/id/eprint/4883

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