Liver retransplantation of patients with hepatitis C infection is associated with acceptable patient and graft survival

Liver retransplantation of patients with hepatitis C infection is associated with acceptable patient and graft survival

Infection with hepatitis C virus (HCV) is the leading cause of liver transplantation (LT), while liver retransplantation (RT) for HCV is controversial as a result of concerns over poor outcomes. We sought to compare patient and graft survival after RT in patients with and without HCV. We performed a...

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Bibliographic Details
Published in:Liver transplantation Vol. 13; no. 12; pp. 1717 - 1727
Main Authors: Ghabril, Marwan, Dickson, Rolland C., Machicao, Victor I., Aranda‐Michel, Jaime, Keaveny, Andrew, Rosser, Barry, Bonatti, Hugo, Krishna, Murli, Yataco, Maria, Satyanarayana, Raj, Harnois, Denise, Hewitt, Winston, Willingham, Darin D., Grewal, Hani, Hughes, Christopher B., Nguyen, Justin
Format: Journal Article
Language:English
Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-12-2007
Subjects:
Adult
Age Factors
Aged
Donors
Follow-Up Studies
Graft Rejection - prevention & control
Graft Rejection - virology
Graft Survival - drug effects
Grafts
Hepatitis C
Hepatitis C - mortality
Hepatitis C - surgery
Hepatitis C virus
Humans
Immunosuppressive Agents - pharmacology
Immunosuppressive Agents - therapeutic use
Infection
Kaplan-Meier Estimate
Liver Transplantation
Middle Aged
Mortality
Patient Selection
Recurrence
Rejection
Reoperation
Retrospective Studies
Survival
Time Factors
Tissue Donors
Treatment Outcome
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Summary:Infection with hepatitis C virus (HCV) is the leading cause of liver transplantation (LT), while liver retransplantation (RT) for HCV is controversial as a result of concerns over poor outcomes. We sought to compare patient and graft survival after RT in patients with and without HCV. We performed a retrospective chart review of all patients undergoing RT at our center between February 1998 and April 2004. Indications for RT, HCV status, patient, and donor characteristics, laboratory values, and hospitalization status at RT were collected. A total of 108 patients (48 HCV and 60 non‐HCV) underwent RT during the study period, with mean post‐RT follow‐up of 1,096 days (range, 0‐2,888 days). Grafts from donors aged >60 years were used less frequently in HCV patients at RT (6%) compared with LT (47%), P < 0.001. There was no difference between HCV vs. non‐HCV patients in 1‐ and 3‐year patient survival (respectively, 79% vs. 63%, and 71% vs. 63%) and graft survival (respectively, 67% vs. 66%, and 59% vs. 56%). Post‐RT mortality and graft failure in HCV patients occurred within the first year in 89% of patients, and 83% were unrelated to HCV recurrence. We conclude that patients should not be excluded from consideration for retransplantation solely on the basis of a diagnosis of HCV. Liver Transpl 13:1717–1727, 2007. © 2007 AASLD.
Bibliography:Telephone: 904‐296‐5876; FAX: 904‐296‐5874
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ISSN:1527-6465
1527-6473
DOI:10.1002/lt.21292