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Recurrent hepatitis C posttransplant: early preservation injury may predict poor outcome.
Liver Transpl 2006; 12(1):134-9LT

Abstract

Organ cold/warm ischemia is thought to be a risk factor for increased severity of recurrence of hepatitis C (HCV) post liver transplantation. We had noted some HCV patients with preservation injury (PI) to have particularly poor outcomes. Our goal was to determine if PI on biopsy in HCV patients is associated with earlier, more rapidly progressive recurrence or graft and patient survival. Sixty-nine patients from the University of Nebraska transplant database were included: 23 HCV patients with PI (group = 1), 23 non-HCV patients with PI (group = 2), and 23 HCV patients without PI (group = 3). Patient groups were matched for gender, age, immunosuppression, and time of transplantation for analysis. No difference in time to recurrence was noted between HCV groups (256 vs. 316 days posttransplant). More patients in group 1 had progression to stage 3 or 4 fibrosis, compared to group 3 (43 vs. 9%, P = 0.02). One-year survival for groups 1, 2, and 3 was 78, 82, and 100% respectively, whereas 3-yr survival was 59, 82, and 88% (group 1 vs. group 2 or 3 respectively, P = 0.0055). There was no difference in survival between groups 2 and 3. Patients in group 1 that received antiviral treatment had improved survival, compared to those who did not (P = 0.012). Risk factors for poor survival on univariate analysis included severity of PI (Relative Risk = 2.78, P < 0.001) and donor age of >55 (P = 0.014). Multivariate analysis shows HCV is the most important factor. In conclusion, HCV transplant patients with evidence of early PI on biopsy have poorer survival outcomes than non-HCV transplant patients with PI or HCV transplant patients without PI. Consideration for antiviral therapy early in the posttransplant course may be warranted in this subset of patients.

Authors+Show Affiliations

Internal Medicine/GI/Hepatology, Dalhousie University, Halifax, Nova Scotia, Canada. wattk@cdha.nshealth.caNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16382465

Citation

Watt, Kymberly D S., et al. "Recurrent Hepatitis C Posttransplant: Early Preservation Injury May Predict Poor Outcome." Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, vol. 12, no. 1, 2006, pp. 134-9.
Watt KD, Lyden ER, Gulizia JM, et al. Recurrent hepatitis C posttransplant: early preservation injury may predict poor outcome. Liver Transpl. 2006;12(1):134-9.
Watt, K. D., Lyden, E. R., Gulizia, J. M., & McCashland, T. M. (2006). Recurrent hepatitis C posttransplant: early preservation injury may predict poor outcome. Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 12(1), pp. 134-9.
Watt KD, et al. Recurrent Hepatitis C Posttransplant: Early Preservation Injury May Predict Poor Outcome. Liver Transpl. 2006;12(1):134-9. PubMed PMID: 16382465.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Recurrent hepatitis C posttransplant: early preservation injury may predict poor outcome. AU - Watt,Kymberly D S, AU - Lyden,Elizabeth R, AU - Gulizia,James M, AU - McCashland,Timothy M, PY - 2005/12/31/pubmed PY - 2006/6/10/medline PY - 2005/12/31/entrez SP - 134 EP - 9 JF - Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society JO - Liver Transpl. VL - 12 IS - 1 N2 - Organ cold/warm ischemia is thought to be a risk factor for increased severity of recurrence of hepatitis C (HCV) post liver transplantation. We had noted some HCV patients with preservation injury (PI) to have particularly poor outcomes. Our goal was to determine if PI on biopsy in HCV patients is associated with earlier, more rapidly progressive recurrence or graft and patient survival. Sixty-nine patients from the University of Nebraska transplant database were included: 23 HCV patients with PI (group = 1), 23 non-HCV patients with PI (group = 2), and 23 HCV patients without PI (group = 3). Patient groups were matched for gender, age, immunosuppression, and time of transplantation for analysis. No difference in time to recurrence was noted between HCV groups (256 vs. 316 days posttransplant). More patients in group 1 had progression to stage 3 or 4 fibrosis, compared to group 3 (43 vs. 9%, P = 0.02). One-year survival for groups 1, 2, and 3 was 78, 82, and 100% respectively, whereas 3-yr survival was 59, 82, and 88% (group 1 vs. group 2 or 3 respectively, P = 0.0055). There was no difference in survival between groups 2 and 3. Patients in group 1 that received antiviral treatment had improved survival, compared to those who did not (P = 0.012). Risk factors for poor survival on univariate analysis included severity of PI (Relative Risk = 2.78, P < 0.001) and donor age of >55 (P = 0.014). Multivariate analysis shows HCV is the most important factor. In conclusion, HCV transplant patients with evidence of early PI on biopsy have poorer survival outcomes than non-HCV transplant patients with PI or HCV transplant patients without PI. Consideration for antiviral therapy early in the posttransplant course may be warranted in this subset of patients. SN - 1527-6465 UR - https://www.unboundmedicine.com/medline/citation/16382465/Recurrent_hepatitis_C_posttransplant:_early_preservation_injury_may_predict_poor_outcome_ L2 - https://doi.org/10.1002/lt.20583 DB - PRIME DP - Unbound Medicine ER -