中文摘要：

目的总结再次肝移植的临床经验。方法回顾性分析1996年5月至2014年3月实施1246例同种异体原位肝移植中38例再次肝移植患者的诊治情况。结果再次肝移植患者38例，发生率为3．0％，其中2007年以前再次肝移植发生率为4．2％，2007年以后为2．1％，差异有统计学意义（χ2=4．519，P=0．034）。再次肝移植的原因主要是：胆道并发症（63．2％）、肝动脉血栓形成（10．5％）、原发病（肿瘤）复发（10．5％）。患者术后1、3、5年生存率分别为73．5％、59．8％和59．8％，根据首次肝移植和再次肝移植的间隔时间分组。30d内再移植组和30d后再移植组的术后累计生存率比较，差异无统计学意义（Log—Rank检验,χ2=0．125，P=0．724）。再移植的术后并发症主要是感染（44．7％）、急性排斥反应（26．3％）、胆道并发症（18．4％）、腹腔内出血（10．5％）、肝动脉栓塞（5．3％）和慢性排斥反应（5．3％）。围术期并发症主要是腹腔内出血和急性排斥反应。结论再次肝移植能有效挽救首次肝移植术后移植肝功能衰竭患者的生命。

英文摘要：

Objective To summarize the clinical experience in liver retransplantation. Methods Clinical data of 38 cases of liver retransplantation since May 1996 to March 2014 were retrospectively analyzed. Results Among the 1 246 cases of orthotopie liver transplantation, 38 had liver retranspalantation, the incidence was 3.0%. Incidence of retransplantation before 2007 was 4.2%, significantly higher than that after 2007, which was 2. 1% （χ2 =4. 519 ,P =0. 034） ;the main causes of liver retransplantations were biliary complication（63.2% ）, hapetic artery thrombosis（ 10. 5% ） , primary disease （tumor） recurrence（ 10. 5% ） ; the 1 year,3 year and 5 year patient survival rates were 73.5% ,59. 8% and 59.8%, respectively. The accumulative patient survival rate was not significantly different between those receiving a second liver 〈30 d after primary transplant and those 〉 30 d （Log-Rank test,χ2 = 0. 125 ,P = 0. 724）. Posttransplant complications were mainly infection （ 44. 7% ） , acute rejection （ 26. 3% ） , biliary complication（ 18.4 ）, intraperitoneal hemorrhage （ 10.5% ）, hepatic artery thrombosis （ 5.3% ） and chronic rejection（ 5.3% ）. The main periopretive complications included intraperitoneal hemorrhage and acute rejection. Conclusions Liver retransplantation prolongs patients＇ survival who had suffered from graft failure after primary liver transplantation.