title: Impact of hepatitis C virus status in pancreas transplantation: a case controlled study.
abstract: Available data suggest that hepatitis C virus positive (HCV+) renal transplant patients may be at an increased risk of morbidity and mortality compared with HCV- patients. Limited data are available regarding the impact of HCV status in pancreas transplant patients. We compared the outcomes of 10 HCV+ patients undergoing pancreas transplantation (seven simultaneous kidney-pancreas, one pancreas after kidney, two pancreas alone) between 1/96 and 10/99 with 20 HCV- recipients that were matched for age, race, gender, timing of transplant, type of pancreas transplant, and surgical technique. Length of follow-up was not significantly different between the HCV+ group compared with the HCV- group (24 +/- 14 vs. 20 +/- 13 months; p=0.45). There was a trend toward a higher incidence of all cause mortality in HCV+ recipients compared with HCV- recipients, 30 vs. 10%, respectively (p=0.17). Additionally, the HCV+ recipients had a trend toward a higher incidence of sepsis-related mortality compared with HCV- recipients, 20 vs. 5%, respectively (p=0.19). Renal allograft survival was 50% in the HCV+ group compared with 94% in the HCV- group (p=0.02). Pancreas allograft survival was not significantly different between the groups, 60 vs. 80%, respectively (p=0.24). At 3, 6, 12 months, and end of follow-up, there were no differences in serum creatinine, amylase, C-peptide, or fasting glucose levels. However, there was a significantly higher incidence of proteinuria at last follow-up in the HCV+ recipients with a renal allograft when compared with HCV- recipients, 50 vs. 12.5%, respectively (p=0.05). In order to maintain comparable glycemic control between the groups, there was a significant increase in oral hypoglycemic requirement in HCV+ recipients compared with HCV- recipients, 33 vs. 0%, respectively (p=0.01). These data suggest that HCV+ pancreas transplant patients may be at an increased risk of graft dysfunction and morbidity. Further studies with more patients and longer follow-up are needed to fully define the impact of HCV status on pancreas graft survival and function.
authors.affiliation: Department of Pharmacy, University of Tennessee, Memphis, TN 38163, USA.
authors.forename: Marsha R
authors.initials: MR
authors.lastname: Honaker
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Stratta
authors.forename: Agnes
authors.initials: A
authors.lastname: Lo
authors.forename: M Francesca
authors.initials: MF
authors.lastname: Egidi
authors.forename: M Hosein
authors.initials: MH
authors.lastname: Shokouh-Amiri
authors.forename: Hani P
authors.initials: HP
authors.lastname: Grewal
authors.forename: Rita R
authors.initials: RR
authors.lastname: Alloway
authors.forename: Lillian W
authors.initials: LW
authors.lastname: Gaber
authors.forename: Karen L
authors.initials: KL
authors.lastname: Hardinger
authors.forename: A Osama
authors.initials: AO
authors.lastname: Gaber
mesh_terms: D016022:Case-Control Studies; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006085:Graft Survival; D006526:Hepatitis C; D006801:Humans; D009017:Morbidity; D016035:Pancreas Transplantation / Q000401:mortality; D011379:Prognosis; D012306:Risk