A retrospective analysis of re-exploration after living donor right lobe liver transplantation: incidence, causes, outcomes, and risk factors

Transpl Int. 2019 Feb;32(2):141-152. doi: 10.1111/tri.13335. Epub 2018 Oct 2.

Abstract

Despite technical difficulties, right lobe liver grafting is preferred in living donor liver transplantation because of the graft size. Re-exploration after living donor right lobe liver transplantation (LRLT) has never been separately analyzed. We aimed to analyze the incidence, causes, outcomes, and risk factors of re-exploration after LRLT. We reviewed medical records of 1016 LRLT recipients from October 2003 to July 2017 and identified recipients who underwent re-exploration within hospital stay. Separate analyses were also performed according to cause of re-exploration. The overall incidence of re-exploration was 17.0% (173/1016). The most common cause of re-exploration was bleeding (50%). Overall re-exploration was associated with clinical outcome, but different results were shown on analyses according to cause of re-exploration. Risk factors of re-exploration were underlying hepatocellular carcinoma and operative duration [Odds ratio (OR), 1.49; 95% confidence interval (CI), 1.05-2.12; P = 0.03, and OR, 1.002; 95% CI, 1.001-1.004; P = 0.0023, respectively]. Re-exploration after LRLT is relatively common, and is strongly associated with mortality and graft failure.

Keywords: incidence; living donor right lobe liver transplantation; outcome; re-exploration.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Hepatocellular / surgery
  • End Stage Liver Disease / surgery*
  • Female
  • Graft Survival
  • Hemorrhage / etiology
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Incidence
  • Length of Stay
  • Liver / pathology*
  • Liver / surgery
  • Liver Neoplasms / surgery
  • Liver Transplantation / methods*
  • Living Donors*
  • Male
  • Medical Records
  • Middle Aged
  • Odds Ratio
  • Organ Size
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Immunosuppressive Agents