Liver TX for hepatitis C cirrhosis in a low prevalence population: risk factors and status at evaluation.
OBJECTIVE
Hepatitis C virus (HCV) cirrhosis is the most common indication for liver transplantation (LTX) world-wide. The prevalence of HCV infections is much lower in Norway than in most other countries from which data on HCV infection and liver transplantation have been published.


METHODS
Patients with HCV infection referred for evaluation of a possible LTX between 1990 and 2005 were included in the study. Their clinical status, biochemical parameters and risk factors were recorded. All patients were followed until 1 January 2005 irrespective of transplantation status.


RESULTS
Fifty-one patients were included; 80% were males and 18% were non-Caucasians. Previous intravenous drug abuse (28%) and exposure to contaminated IgG products (15%) were the most common routes of infection. In 45/51 (88%) of the evaluated patients at least one risk factor for rapid progression of HCV disease was identified. Twenty-seven patients were accepted on the waiting list. The MELD (model for endstage liver disease) score for the accepted patients was significantly higher than that for the patients who were not listed because they were found to be too healthy (18.4 versus 12.1, p<0.01). Twenty-four patients (89% of those listed) received a liver allograft; their 1-, 3- and 5-year survival rates following LTX were 81%, 68% and 68%, respectively. Two patients needed a second transplantation.


CONCLUSIONS
A low number of HCV-infected patients have so far been evaluated for LTX in Norway. The present study demonstrates that almost all of the HCV patients progressing to cirrhosis and being evaluated for LTX in Norway have additional risk factors for development of cirrhosis.
Melum
Espen
E
Section of Gastroenterology and Hepatology, Department of Medicine, Rikshospitalet, Oslo, Norway.
Schrumpf
Erik
E
Bjøro
Kristian
K
D000328:Adult; D006526:Hepatitis C / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000601:surgery* / Q000821:virology*; D016031:Liver Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D009664:Norway / Q000453:epidemiology; D015995:Prevalence; D012086:Reoperation; D016019:Survival Analysis; D016896:Treatment Outcome