BACKGROUND & AIMS: The effect of hepatitis C viral (HCV) infection on patient and allograft survival after orthotopic liver transplantation is controversial. Hepatitis C recurrence after transplant is inevitable, but studies to date have not found a survival difference between recipients with and without HCV. METHODS: Using data from the United Network for Organ Sharing, we performed a retrospective cohort study of 11,036 patients who underwent 11,791 liver transplants between 1992 and 1998. The hazard rates of patient and allograft survival for patients who were HCV-positive as compared with patients who were HCV-negative were assessed by proportional-hazards analysis, with adjustment for potential confounding variables, including donor, recipient, and transplant center characteristics. RESULTS: Liver transplantation in HCV-positive recipients was associated with an increased rate of death (hazard ratio, 1.23; 95% confidence interval [CI], 1.12-1.35) and allograft failure (hazard ratio, 1.30; 95% CI, 1.21-1.39), as compared with transplantation in HCV-negative recipients. This reduction in survival persisted after adjusting for potential confounders. There was an interaction between HCV and sex (P < 0.001) with the effect of HCV on survival being most pronounced in female recipients (patient survival hazard ratio, 1.56; 95% CI, 1.35-1.81; allograft survival hazard ratio, 1.51; 95% CI, 1.34-1.70). CONCLUSIONS: HCV infection significantly impairs patient and allograft survival after liver transplantation.
BACKGROUND & AIMS: The effect of hepatitis C viral (HCV) infection on patient and allograft survival after orthotopic liver transplantation is controversial. Hepatitis C recurrence after transplant is inevitable, but studies to date have not found a survival difference between recipients with and without HCV. METHODS: Using data from the United Network for Organ Sharing, we performed a retrospective cohort study of 11,036 patients who underwent 11,791 liver transplants between 1992 and 1998. The hazard rates of patient and allograft survival for patients who were HCV-positive as compared with patients who were HCV-negative were assessed by proportional-hazards analysis, with adjustment for potential confounding variables, including donor, recipient, and transplant center characteristics. RESULTS: Liver transplantation in HCV-positive recipients was associated with an increased rate of death (hazard ratio, 1.23; 95% confidence interval [CI], 1.12-1.35) and allograft failure (hazard ratio, 1.30; 95% CI, 1.21-1.39), as compared with transplantation in HCV-negative recipients. This reduction in survival persisted after adjusting for potential confounders. There was an interaction between HCV and sex (P < 0.001) with the effect of HCV on survival being most pronounced in female recipients (patient survival hazard ratio, 1.56; 95% CI, 1.35-1.81; allograft survival hazard ratio, 1.51; 95% CI, 1.34-1.70). CONCLUSIONS:HCV infection significantly impairs patient and allograft survival after liver transplantation.
Authors: Jennifer E Layden; Scott J Cotler; Shellee A Grim; Michael J Fischer; Michael R Lucey; Nina M Clark Journal: Transplantation Date: 2012-02-27 Impact factor: 4.939
Authors: Kymberly D S Watt; Kelly Burak; Marc Deschênes; Les Lilly; Denis Marleau; Paul Marotta; Andrew Mason; Kevork M Peltekian; Eberhard L Renner; Eric M Yoshida Journal: Can J Gastroenterol Date: 2006-11 Impact factor: 3.522
Authors: Malcolm Wells; Kris M Croome; Toni Janik; Roberto M Hernandez-Alejandro; Natasha M Chandok Journal: Can J Gastroenterol Hepatol Date: 2013-11-28
Authors: Jennifer E Layden; Bamidele O Tayo; Scott J Cotler; Nina M Clark; Kristine Baraoidan; Scott L Friedman; Richard S Cooper Journal: Transplantation Date: 2014-05-27 Impact factor: 4.939
Authors: Peter L Abt; Niraj M Desai; Michael D Crawford; Lisa M Forman; Joseph W Markmann; Kim M Olthoff; James F Markmann Journal: Ann Surg Date: 2004-01 Impact factor: 12.969