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When to Re-explore Recipients in LRLT

Selvakumar Naganathan, Mohammed Nayeem, Neerav Goyal, Subash Gupta

Re-exploration is one of the surgical complications of living donor liver transplantations. Re-explorations are of two types planned and unplanned. Unplanned re-exploration does always mean poor prognosis to the patient outcome? Was the aim of our study? We analysed retrospectively prospectively maintained data from Jan 2011 to August 2013. Total number of transplants done was 793. Total number of re-explorations was 80 in 66 patients. Reexploration rate was 10.08%. Total mortality in our series was 10.5%. Mortality in Re-exploration group was 45.45%. Of the group of patients re-explored patients re-explored for early haemorrhage had better outcomes compared to patients explored for other reasons. Re-explored patients are at higher risk of fungal infections. Patients with multiple bile ducts are at higher risk of re-explorations. Patients re-explored in the immediate post-operative period had better outcomes compared to patients re-explored late. Overall it is a poor prognostic indicator of surgical outcome in living donor liver transplantation.