LIVER RETRANSPLANTATION. 67 CASES EXPERIENCE.

One unoubtedly significant factor in the improved results of liver transplant constitutes the most common indication of retransplantation,since progrssively and severely the graft function worsen, the only chance to save the patient life is liver retransplantation. Report experience with 67 PATIENTS AND METHODS. In the period between April 1986 to November 1994, 402 liver transplants heve been performed in the "Doce de Octubre" hospital,67 were retransplants:48 adults and 19 children. In 54 of second graft-first retransplant (41 adults, 13 children), 12 of third graft-second retransplant (6 adults, 6 children), and 1 of fourth graft-third retransp1ant (1 adult). Primary function and chronic rejection represent the 70% of indications of retransplant. From 67 grafts, 12 were reduced size liver and the remainder whole grafts. RESULTS. The peroperative mortality represent 22,2%, 12 patients (3 intraoperative, 9 in the first 28 days), in the follow up dead 13 patients (24%), for overall mortality of 25 patients (46,29%). The actuarial overall survival, excluding the peroperative mortality are: 85,5% at first year, 71,6% at third y,and 59,4% at fifth y. The survival of first grafts are 35,1% at six months, 20,3% at first y, 11,1% at second y, 3% at third y, and 0% at fourth y. The survival of second grafts 53,1% at first y, 46,4% at third y, 42,2% at fifth y. COMMENTS. The present results suggests that hepatic retransplant is valid option when is required only chnace of treatment. The main point is that the indication have to be accurate. A third fourth transplant can be performed with good results. The long term survival is similar to the patients evolution with one only transplant.