Original Contributions *Staff Surgeon †Staff Anesthesiologist ‡Medical Student §Professor and Chairman of Anesthesia ¶Professor and Chairman of Surgery Address correspondence and reprint re- quests to Dr. Glanemann at the Department of General-, Visceral- & Transplantation Sur- gery, Charite ´, Campus Virchow Klinikum, Humboldt University Berlin, Augusten- burger Platz 1, 13353 Berlin, Germany. E- mail: matthias.glanemann@charite.de Received for publication February 6, 2001; revised manuscript accepted for publication May 16, 2001. Incidence and Indications for Reintubation During Postoperative Care Following Orthotopic Liver Transplantation Matthias Glanemann, MD,* Udo Kaisers, MD, PhD,† Jan M. Langrehr, MD, Phd,* Rolando Schenk, ‡ Barbara J. Stange, MD,* Andrea R. Mu ¨ller, MD, PhD,* Wolf-Otto Bechstein, MD, PhD,* Konrad Falke, MD, PhD,§ Peter Neuhaus MD, PhD,¶ Department of General-, Visceral- & Transplantation Surgery, and Department of Anesthesiology and Intensive Care Medicine, Charite ´, Campus Virchow Klinikum, Humboldt University Berlin, Berlin, Germany Study Objective: To analyze the incidence and indications for reintubation during postoperative care following orthotopic liver transplantation (OLT). Design: Retrospective chart review. Setting: Large metropolitan teaching hospital. Patients: 546 adult liver transplant recipients. Measurements and Main Results: The medical charts of 546 patients who underwent OLT at our institution between January 1992 and September 1996 were reviewed for the incidence and indications of reintubation throughout primary hospitalization. Eighty-one of 546 patients (14.8%) required one or more episodes of reintubation after OLT. In the majority of cases, reintubation was performed for pulmonary complications (44.6%), followed by cerebral (19.1%) and surgical (14.5%) complications. Cardiac (9.1%) and peripheral neurologic (2.7%) complications were less frequent reasons for reintubation. Overall patient survival, according to the Kaplan-Meier estimates, was 89.9%, 87.5%, 86.5%, and 82.2% after 1, 2, 3, and 5 years, respectively. In patients with one or more episodes of reintubation, overall survival decreased to 62.5% after 1, 2, and 3 years, and to 56.4% after 5 years (p  0.001). Conclusions: The main indications for reintubation after OLT were pulmonary, cerebral, and surgical complications. These reintubation events had a considerable influence on the patient’s postoperative recovery, and were associated with a significantly higher rate of mortality, than for OLT patients who did not undo reintubation. © 2001 by Elsevier Science Inc. Keywords: liver transplantation, pneumonia, postoperative care, reintubation. Journal of Clinical Anesthesia 13:377–382, 2001 © 2001 Elsevier Science Inc. All rights reserved. 0952-8180/01/$–see front matter 655 Avenue of the Americas, New York, NY 10010 PII S0952-8180(00)00290-2