Is primary nonfunction still a suitable indication for liver retransplantation?

Primary dysfunction after liver transplantation, today remains an important determinant of patient survival even with recent improvements in postoperative support therapy. PD is a multifactorial event and donor factors probably play a minor role in determining PD; recipient factors, particularly preoperative bilirubin level, intraoperative blood infusion, and bypass time are the strongest predictors of PD. The combination of donor and recipient factors, their multiplicity, and the low grade of correlation between each factor and PD explain the difficulty in the reduction of primary dysfunction after liver transplantation.