title: European collaborative study on factors influencing outcome after liver transplantation for hepatitis C. European Concerted Action on Viral Hepatitis (EUROHEP) Group.
abstract: OBJECTIVE
  Liver transplantation for hepatitis C virus (HCV)-related liver disease is characterized by frequent graft infection by HCV. The prognosis and risk factors for morbidity and mortality in this condition were determined.
  
  
  METHODS
  A retrospective study of 652 consecutive anti-HCV-positive patients undergoing liver transplantation between 1984 and 1995 in 15 European centers was conducted; 102 patients coinfected with hepatitis B virus (HBV) received immunoglobulin prophylaxis for antibody to hepatitis B surface antigen.
  
  
  RESULTS
  Overall, 5-year survival was 72%. Five-year actuarial rates of hepatitis and cirrhosis were 80% and 10%. Genotypes 1b, 1a, and 2 were detected in 214 (80%), 24 (9%), and 24 (9%) of 268 patients analyzed. The only discriminant factor for patient or graft survival was hepatocellular carcinoma as primary indication. Independent risk factors for recurrent hepatitis included the absence of HBV coinfection before transplantation (relative risk [RR], 1.7; 95% confidence interval [CI], 1.2-2.6; P = 0.005), genotype 1b (RR, 2; 95% CI, 1.3-2.9; P = 0.01), and age > 49 years (RR, 1.4; 95% CI, 1.1-1.8; P = 0.01).
  
  
  CONCLUSIONS
  The results of transplantation for HCV-related disease are compromised by a significant risk of cirrhosis, although 5-year survival is satisfactory. Genotype 1b, age, and absence of pretransplantation coinfection by HBV are risk factors for recurrent HCV.
authors.affiliation: Centre Hépato-Biliaire, Hôpital Paul Brousse, CRI 9804, Villejuif, France.
authors.forename: C
authors.initials: C
authors.lastname: Féray
authors.forename: L
authors.initials: L
authors.lastname: Caccamo
authors.forename: G J
authors.initials: GJ
authors.lastname: Alexander
authors.forename: B
authors.initials: B
authors.lastname: Ducot
authors.forename: J
authors.initials: J
authors.lastname: Gugenheim
authors.forename: T
authors.initials: T
authors.lastname: Casanovas
authors.forename: C
authors.initials: C
authors.lastname: Loinaz
authors.forename: M
authors.initials: M
authors.lastname: Gigou
authors.forename: P
authors.initials: P
authors.lastname: Burra
authors.forename: L
authors.initials: L
authors.lastname: Barkholt
authors.forename: R
authors.initials: R
authors.lastname: Esteban
authors.forename: T
authors.initials: T
authors.lastname: Bizollon
authors.forename: J
authors.initials: J
authors.lastname: Lerut
authors.forename: A
authors.initials: A
authors.lastname: Minello-Franza
authors.forename: P H
authors.initials: PH
authors.lastname: Bernard
authors.forename: K
authors.initials: K
authors.lastname: Nachbaur
authors.forename: D
authors.initials: D
authors.lastname: Botta-Fridlund
authors.forename: H
authors.initials: H
authors.lastname: Bismuth
authors.forename: S W
authors.initials: SW
authors.lastname: Schalm
authors.forename: D
authors.initials: D
authors.lastname: Samuel
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012367:RNA, Viral / Q000032:analysis; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D012367:RNA, Viral