Liver retransplantation in adult recipients: analysis of a 38-year experience in the Netherlands

Kosei Takagi, Piotr Domagala, Robert J. Porte, Ian Alwayn, Herold J. Metselaar, Aad P. van den Berg, Bart van Hoek, Jan N.M. Ijzermans, Wojciech G. Polak

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Background: Liver retransplantation (re-LT) accounts for up to 22% after primary liver transplantation (LT), and using donor livers for retransplantation can only be justified by successful outcomes. Methods: A total of 2,387 adult recipients with 2,778 LT, between 1979 and 2017, were analyzed to determine risk factors and outcome of re-LT in the Netherlands. Results: Of 2,778 LT, 336 (12.1%) were first, 43 (1.5%) were second, and 12 (0.5%) were third or fourth re-LT. The 5-year patient survival for primary LT, and first, second, and third or fourth re-LT were 74.0%, 70.8%, 63.3%, and 57.1%, respectively (P = 0.10). Recipient age (≤60 years) (OR 1.96, P < 0.001), era (1979–2006) (OR 1.56, P = 0.003), donor after circulatory death (DCD) (OR 1.96, P < 0.001), and cold ischemia time (CIT) (>9 h) (OR 1.42, P = 0.007) were significant risk factors for retransplantation after primary LT. Conclusions: Recipient age, era, DCD, and prolonged CIT were identified as parameters for retransplantation. The outcome after the first re-LT was good, and comparable to those of primary transplants. Survival after multiple re-LT was not significantly different from the first retransplant group, legitimizing third and fourth re-LT to well-selected patients.

Original languageEnglish
Pages (from-to)26-33
Number of pages8
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Issue number1
Publication statusPublished - Jan 1 2020
Externally publishedYes


  • Liver retransplantation
  • Outcome

ASJC Scopus subject areas

  • Medicine(all)


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