目的:总结再次肝移植病人围手术期临床特点和管理经验。方法:回顾分析中山大学附属第三医院肝移植中心2004年1月至2006年12月期间施行的34例再次肝移植受者临床资料。结果:再次肝移植的原因分别为移植术后胆道并发症（18例）、移植术后肝癌复发（6例）、肝炎复发（6例）以及肝动脉并发症（4 例）。34例均采用附加腔静脉整形的改良背驮式肝移植技术。全组无手术死亡。院内死亡9例（26.5％），明显高于首次肝移植的病死率（6.9％，46/671)（P<0.05）。死亡原因中感染占556%(5/9)。再次肝移植组术前感染率为32.4%(11/34)，首次肝移植组为10.7%(72/671)，两组间差异有显著性意义（P<0.05）。再次肝移植组术后感染率为61.8％(21/34)，首次肝移植组为46.3%(311/671)，两组相比差异无显著性意义（P>0.05）。结论:感染是再移植的主要死亡原因，围手术期有效的抗感染治疗和针对再次肝移植特点的个体化免疫抑制方案可以提高再次肝移植的成功率。

Objective:To conclude the perioperative clinical character and management experience of liver retransplantation (ReTx). Methods:The clinical data of 34 patients undergone liver retransplantation at the liver transplantation center of the Third Affiliated Hospital of Sun Yet-sen University from January 2004 to December 2006 were retrospectively analyzed. The retransplantation indications included biliary complications (18 cases)，recurrence of HCC (6 cases),hepatitis recurrence (6 cases) and hepatic artery complication (4 cases).34 patients received modified piggyback liver transplantation. Results:No patient died during operation.9 patients (26.5%) died in hospital, which was significant higher than that of the first transplantation (6.9%,46/671)(P<0.05).Infection accounted for 55.6%(5/9).There was significant difference of the preoperative infectious rate between retransplantation and primary transplantation group,which was 32.4%(11/34) and 10.88%(72/671) respectively (P<0.05).There was no significant difference of the postoperative infectious rate between retransplantation and primary transplantation group,which was 61.8%(21/34) and 46.3%(311/671) respectively (P>0.05). Conclusion:Infection is the main cause of death in liver retransplantation.Effective perioperative antiinfection treatment and reasonable individual immunosuppression regime refer to liver retransplantation may increase the success rate of liver retransplantion.