Literature DB >> 21764330

Decreased post-transplant survival among heart transplant recipients with pre-transplant hepatitis C virus positivity.

Ingi Lee1, Russell Localio, Colleen M Brensinger, Emily A Blumberg, Ebbing Lautenbach, Leanne Gasink, Valerianna K Amorosa, Vincent Lo Re.   

Abstract

BACKGROUND: Transplant centers are reluctant to perform heart transplantation in patients with hepatitis C virus (HCV) infection because augmented immunosuppression could potentially increase mortality. However, there have been few studies examining whether HCV infection reduces survival after heart transplantation.
METHODS: We used data from the the U.S. Scientific Registry of Transplant Recipients to perform a multicenter cohort study evaluating the association between recipient pre-transplant HCV status and survival after heart transplantation. Adults undergoing heart transplantation between January 1, 1993 and December 31, 2007 were eligible to participate.
RESULTS: Among 20,687 heart transplant recipients (443 HCV-positive and 20,244 HCV-negative) at 103 institutions followed for a mean of 5.6 years, mortality was higher among HCV-positive than HCV-negative recipients (177 [40%] vs 6,367 [31.5%]; p = 0.0001). After matching on propensity score, hospital and gender, the hazard ratio (HR) of death for HCV-positive heart transplant recipients was 1.32 (95% confidence interval [CI] 1.08 to 1.61). Mortality rates were higher among HCV-positive heart transplant recipients at 1 year (9.4% vs 8.2%), 5 years (26.3% vs 22.9%), 10 years (53.1% vs 43.4%) and 15 years (74.8% vs 62.3%) post-transplantation. HRs did not vary by gender or overall number of heart transplantations performed at the center.
CONCLUSIONS: Pre-transplant HCV positivity is associated with decreased survival after heart transplantation. 2011 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

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Year:  2011        PMID: 21764330      PMCID: PMC3223534          DOI: 10.1016/j.healun.2011.06.003

Source DB:  PubMed          Journal:  J Heart Lung Transplant        ISSN: 1053-2498            Impact factor:   10.247


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