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The impact of hepatitis C and biliary complications on patient and graft survival following liver transplantation.
Am J Transplant 2009; 9(6):1398-405AJ

Abstract

Recurrent hepatitis C (HCV) and biliary complications (BC) are major causes of post liver transplant morbidity and mortality. The impact of these complications may be additive or synergistic. We performed a retrospective cohort study to analyze the effects of HCV and BC on all patients transplanted at two institutions over 6 years. BC was defined by imaging findings in the setting of abnormal liver function tests that required intervention. The primary outcomes were graft and patient survival over a mean 3.4 years. 709 patients (619 deceased, 90 living donor) were included, 337 with HCV and 372 without. BC was diagnosed more frequently in patients with HCV, 26% versus 18% (p = 0.008). One-year and overall patient and graft survival were significantly lower in patients with HCV, but BC impacted only 1-year graft survival. The combination of BC and HCV had no additional impact on survival or fibrosis rates on 1-year protocol biopsies. Multivariate analysis revealed HCV (HR 2.1) and HCC (HR 1.9) to be independent predictors of mortality. Since BC are diagnosed more frequently in HCV patients and only affect early graft loss, it is likely that recurrent HCV rather than BC accounts for the majority of adverse graft outcomes.

Authors+Show Affiliations

Center for Liver Disease and Transplantation, New York Presbyterian Hospital, New York, NY, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

19459805

Citation

Verna, E C., et al. "The Impact of Hepatitis C and Biliary Complications On Patient and Graft Survival Following Liver Transplantation." American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, vol. 9, no. 6, 2009, pp. 1398-405.
Verna EC, De Martin E, Burra P, et al. The impact of hepatitis C and biliary complications on patient and graft survival following liver transplantation. Am J Transplant. 2009;9(6):1398-405.
Verna, E. C., De Martin, E., Burra, P., Neri, D., Gaglio, P. J., Emond, J. C., & Brown, R. S. (2009). The impact of hepatitis C and biliary complications on patient and graft survival following liver transplantation. American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 9(6), pp. 1398-405. doi:10.1111/j.1600-6143.2009.02649.x.
Verna EC, et al. The Impact of Hepatitis C and Biliary Complications On Patient and Graft Survival Following Liver Transplantation. Am J Transplant. 2009;9(6):1398-405. PubMed PMID: 19459805.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of hepatitis C and biliary complications on patient and graft survival following liver transplantation. AU - Verna,E C, AU - De Martin,E, AU - Burra,P, AU - Neri,D, AU - Gaglio,P J, AU - Emond,J C, AU - Brown,R S,Jr Y1 - 2009/05/20/ PY - 2009/5/23/entrez PY - 2009/5/23/pubmed PY - 2009/12/16/medline SP - 1398 EP - 405 JF - American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons JO - Am. J. Transplant. VL - 9 IS - 6 N2 - Recurrent hepatitis C (HCV) and biliary complications (BC) are major causes of post liver transplant morbidity and mortality. The impact of these complications may be additive or synergistic. We performed a retrospective cohort study to analyze the effects of HCV and BC on all patients transplanted at two institutions over 6 years. BC was defined by imaging findings in the setting of abnormal liver function tests that required intervention. The primary outcomes were graft and patient survival over a mean 3.4 years. 709 patients (619 deceased, 90 living donor) were included, 337 with HCV and 372 without. BC was diagnosed more frequently in patients with HCV, 26% versus 18% (p = 0.008). One-year and overall patient and graft survival were significantly lower in patients with HCV, but BC impacted only 1-year graft survival. The combination of BC and HCV had no additional impact on survival or fibrosis rates on 1-year protocol biopsies. Multivariate analysis revealed HCV (HR 2.1) and HCC (HR 1.9) to be independent predictors of mortality. Since BC are diagnosed more frequently in HCV patients and only affect early graft loss, it is likely that recurrent HCV rather than BC accounts for the majority of adverse graft outcomes. SN - 1600-6143 UR - https://www.unboundmedicine.com/medline/citation/19459805/The_impact_of_hepatitis_C_and_biliary_complications_on_patient_and_graft_survival_following_liver_transplantation_ L2 - https://doi.org/10.1111/j.1600-6143.2009.02649.x DB - PRIME DP - Unbound Medicine ER -