LAUSR

Purpose: Globally, there is a growing disparity in the number of liver trans- plant candidates and corresponding availability of suitable liver allografts. To ensure proper utilization and allocation of this precious resource it is important to identify risk factors for graft failure and consequent need for re-transplantation. Outcomes over a 30-year period were examined to iden- tify speci fi c factors associated with graft failure and re-transplantation. Methods: A retrospective analysis of the prospectively maintained South Australian Liver Transplant Unit surgical database (1992 – 2022) was performed. Secondary data was additionally collected from patient records. Patient survival was calculated using a mixed-effect cox model. Multivariate Cox Proportional hazard model analysis was performed to identify risk fac- tors for re-transplantation. Results: 471 liver transplants on 451 patients including 161 (35.7%) females were performed in the study period. Alcohol related cirrhosis (33%) was the most frequent indication for transplantation. Overall survival rates were 95%, 86.2% and 73.6% at 1-, 5-, and 10-years respectively. The most common indication for re-transplant was biliary complications (20%). Hepatic artery thrombosis occurred in 3 patients and primary non-function in 1 patient. Recipient MELD at transplantation ( P < 0.016), donor CMV (p < 0.035), recipient CMV ( P < 0.026) and graft fat content >40% ( P < 0.020) were signi fi cant risk factors for re-transplantation. Donor age ( P < 0.017) and fat content ( P < 0.023) were signi fi cant predictors of patient survival. Conclusions: The risk factors for graft failure necessitating re-transplantation identi