Indications, skills and immunosuppression of late liver re-transplantation caused by rare postoperative complication:report of 5 cases

ZHANG Shao-hui; ZANG Yun-jin; FAN Ning; LU Bin

doi:10.3969/j.issn.1002-266X.2015.015.004

Abstract：Objective To analyze the patients'clinical data of re-operation of liver re-transplantation caused by rare etiology and to discuss the choice of the indications, skills and immunosuppression of late liver transplantation. Methods Five cases of patients after liver transplantation for the first time receiving liver re-transplantation were se-lected.The indications consisted of chronic rejection (4 cases) and idiopathic portal hypertension (1 case).Five pa-tients after liver transplantation for the first time received liver re-transplantation in 6-14 months, and all cases adopt the classic orthotopic liver transplantation ( OLT) .The postoperative immunosuppression schemes of 4 cases were the triple immunosuppressive therapy of tacrolimus (FK506), mycophenolate mofetil (MMF) and hormone; and 1 case applied cyclosporin combined with hormone.Results After one-year follow-up, four patients were cured, and one patient died on week after liver re-transplantation because of poor graft function and respiratory failure.One case had biliary stenosis and then was improved by interventional radiology treatment.no complications and all in good condi-tion.No acute rejection and related complications were found in the postoperative immunosuppression.Conclusions As for patients who received liver transplantation for the first time having chronic rejection and idiopathic portal hyper-tension, late liver re-transplantation should be considered.Controlling the intraoperative bleeding and being familiar with vascular and bile duct reconstruction technique may improve the successful rate of surgery.For patients who re-ceived re-operation of liver re-transplantation, doctors should choose appropriate immunosuppressive scheme, which will help to improve the survival rate of patients.