Cargando…

Outcomes of Liver Resections after Liver Transplantation at a High-Volume Hepatobiliary Center

Although more than one million liver transplantations have been carried out worldwide, the literature on liver resections in transplanted livers is scarce. We herein report a total number of fourteen patients, who underwent liver resection after liver transplantation (LT) between September 2004 and...

Descripción completa

Detalles Bibliográficos
Autores principales: Pohl, Julian M. O., Raschzok, Nathanael, Eurich, Dennis, Pflüger, Michael, Wiering, Leke, Daneshgar, Assal, Dziodzio, Tomasz, Jara, Maximilian, Globke, Brigitta, Sauer, Igor M., Biebl, Matthias, Lurje, Georg, Schöning, Wenzel, Schmelzle, Moritz, Tacke, Frank, Pratschke, Johann, Ritschl, Paul V., Öllinger, Robert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7698397/
https://www.ncbi.nlm.nih.gov/pubmed/33212913
http://dx.doi.org/10.3390/jcm9113685
_version_ 1783615821171392512
author Pohl, Julian M. O.
Raschzok, Nathanael
Eurich, Dennis
Pflüger, Michael
Wiering, Leke
Daneshgar, Assal
Dziodzio, Tomasz
Jara, Maximilian
Globke, Brigitta
Sauer, Igor M.
Biebl, Matthias
Lurje, Georg
Schöning, Wenzel
Schmelzle, Moritz
Tacke, Frank
Pratschke, Johann
Ritschl, Paul V.
Öllinger, Robert
author_facet Pohl, Julian M. O.
Raschzok, Nathanael
Eurich, Dennis
Pflüger, Michael
Wiering, Leke
Daneshgar, Assal
Dziodzio, Tomasz
Jara, Maximilian
Globke, Brigitta
Sauer, Igor M.
Biebl, Matthias
Lurje, Georg
Schöning, Wenzel
Schmelzle, Moritz
Tacke, Frank
Pratschke, Johann
Ritschl, Paul V.
Öllinger, Robert
author_sort Pohl, Julian M. O.
collection PubMed
description Although more than one million liver transplantations have been carried out worldwide, the literature on liver resections in transplanted livers is scarce. We herein report a total number of fourteen patients, who underwent liver resection after liver transplantation (LT) between September 2004 and 2017. Hepatocellular carcinomas and biliary tree pathologies were the predominant indications for liver resection (n = 5 each); other indications were abscesses (n = 2), post-transplant lymphoproliferative disease (n = 1) and one benign tumor. Liver resection was performed at a median of 120 months (interquartile range (IQR): 56.5–199.25) after LT with a preoperative Model for End-Stage Liver Disease (MELD) score of 11 (IQR: 6.75–21). Severe complications greater than Clavien–Dindo Grade III occurred in 5 out of 14 patients (36%). We compared liver resection patients, who had a treatment option of retransplantation (ReLT), with actual ReLTs (excluding early graft failure or rejection, n = 44). Bearing in mind that late ReLT was carried out at a median of 117 months after first transplantation and a median of MELD of 32 (IQR: 17.5–37); three-year survival following liver resection after LT was similar to late ReLT (50.0% vs. 59.1%; p = 0.733). Compared to ReLT, liver resection after LT is a rare surgical procedure with significantly shorter hospital (mean 25, IQR: 8.75–49; p = 0.034) and ICU stays (mean 2, IQR: 1–8; p < 0.001), acceptable complications and survival rates.
format Online
Article
Text
id pubmed-7698397
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-76983972020-11-29 Outcomes of Liver Resections after Liver Transplantation at a High-Volume Hepatobiliary Center Pohl, Julian M. O. Raschzok, Nathanael Eurich, Dennis Pflüger, Michael Wiering, Leke Daneshgar, Assal Dziodzio, Tomasz Jara, Maximilian Globke, Brigitta Sauer, Igor M. Biebl, Matthias Lurje, Georg Schöning, Wenzel Schmelzle, Moritz Tacke, Frank Pratschke, Johann Ritschl, Paul V. Öllinger, Robert J Clin Med Article Although more than one million liver transplantations have been carried out worldwide, the literature on liver resections in transplanted livers is scarce. We herein report a total number of fourteen patients, who underwent liver resection after liver transplantation (LT) between September 2004 and 2017. Hepatocellular carcinomas and biliary tree pathologies were the predominant indications for liver resection (n = 5 each); other indications were abscesses (n = 2), post-transplant lymphoproliferative disease (n = 1) and one benign tumor. Liver resection was performed at a median of 120 months (interquartile range (IQR): 56.5–199.25) after LT with a preoperative Model for End-Stage Liver Disease (MELD) score of 11 (IQR: 6.75–21). Severe complications greater than Clavien–Dindo Grade III occurred in 5 out of 14 patients (36%). We compared liver resection patients, who had a treatment option of retransplantation (ReLT), with actual ReLTs (excluding early graft failure or rejection, n = 44). Bearing in mind that late ReLT was carried out at a median of 117 months after first transplantation and a median of MELD of 32 (IQR: 17.5–37); three-year survival following liver resection after LT was similar to late ReLT (50.0% vs. 59.1%; p = 0.733). Compared to ReLT, liver resection after LT is a rare surgical procedure with significantly shorter hospital (mean 25, IQR: 8.75–49; p = 0.034) and ICU stays (mean 2, IQR: 1–8; p < 0.001), acceptable complications and survival rates. MDPI 2020-11-17 /pmc/articles/PMC7698397/ /pubmed/33212913 http://dx.doi.org/10.3390/jcm9113685 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pohl, Julian M. O.
Raschzok, Nathanael
Eurich, Dennis
Pflüger, Michael
Wiering, Leke
Daneshgar, Assal
Dziodzio, Tomasz
Jara, Maximilian
Globke, Brigitta
Sauer, Igor M.
Biebl, Matthias
Lurje, Georg
Schöning, Wenzel
Schmelzle, Moritz
Tacke, Frank
Pratschke, Johann
Ritschl, Paul V.
Öllinger, Robert
Outcomes of Liver Resections after Liver Transplantation at a High-Volume Hepatobiliary Center
title Outcomes of Liver Resections after Liver Transplantation at a High-Volume Hepatobiliary Center
title_full Outcomes of Liver Resections after Liver Transplantation at a High-Volume Hepatobiliary Center
title_fullStr Outcomes of Liver Resections after Liver Transplantation at a High-Volume Hepatobiliary Center
title_full_unstemmed Outcomes of Liver Resections after Liver Transplantation at a High-Volume Hepatobiliary Center
title_short Outcomes of Liver Resections after Liver Transplantation at a High-Volume Hepatobiliary Center
title_sort outcomes of liver resections after liver transplantation at a high-volume hepatobiliary center
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7698397/
https://www.ncbi.nlm.nih.gov/pubmed/33212913
http://dx.doi.org/10.3390/jcm9113685
work_keys_str_mv AT pohljulianmo outcomesofliverresectionsafterlivertransplantationatahighvolumehepatobiliarycenter
AT raschzoknathanael outcomesofliverresectionsafterlivertransplantationatahighvolumehepatobiliarycenter
AT eurichdennis outcomesofliverresectionsafterlivertransplantationatahighvolumehepatobiliarycenter
AT pflugermichael outcomesofliverresectionsafterlivertransplantationatahighvolumehepatobiliarycenter
AT wieringleke outcomesofliverresectionsafterlivertransplantationatahighvolumehepatobiliarycenter
AT daneshgarassal outcomesofliverresectionsafterlivertransplantationatahighvolumehepatobiliarycenter
AT dziodziotomasz outcomesofliverresectionsafterlivertransplantationatahighvolumehepatobiliarycenter
AT jaramaximilian outcomesofliverresectionsafterlivertransplantationatahighvolumehepatobiliarycenter
AT globkebrigitta outcomesofliverresectionsafterlivertransplantationatahighvolumehepatobiliarycenter
AT sauerigorm outcomesofliverresectionsafterlivertransplantationatahighvolumehepatobiliarycenter
AT bieblmatthias outcomesofliverresectionsafterlivertransplantationatahighvolumehepatobiliarycenter
AT lurjegeorg outcomesofliverresectionsafterlivertransplantationatahighvolumehepatobiliarycenter
AT schoningwenzel outcomesofliverresectionsafterlivertransplantationatahighvolumehepatobiliarycenter
AT schmelzlemoritz outcomesofliverresectionsafterlivertransplantationatahighvolumehepatobiliarycenter
AT tackefrank outcomesofliverresectionsafterlivertransplantationatahighvolumehepatobiliarycenter
AT pratschkejohann outcomesofliverresectionsafterlivertransplantationatahighvolumehepatobiliarycenter
AT ritschlpaulv outcomesofliverresectionsafterlivertransplantationatahighvolumehepatobiliarycenter
AT ollingerrobert outcomesofliverresectionsafterlivertransplantationatahighvolumehepatobiliarycenter