title: Mild donor liver steatosis has no impact on hepatitis C virus fibrosis progression following liver transplantation.
abstract: BACKGROUND
  This study examines the impact of donor liver macrovesicular steatosis on recurrence of hepatitis C virus (HCV) disease after liver transplantation.
  
  
  METHODS
  Between 1998 and 2004, 113 patients underwent liver transplantation for HCV-related cirrhosis. Time to histologic recurrence (fibrosis score >or=2) was the primary endpoint of the study. Recurrence was graded according to the system of Ludwig and Batts. A Cox's proportional hazard regression model was used to analyse the association between donor liver steatosis and HCV recurrence.
  
  
  RESULTS
  Recurrence-free survival for patients who received steatotic grafts was 82% and 47% at 1 and 4 years, respectively, and 81% and 52% for patients who received a non-steatotic liver. Donor macrovesicular steatosis (5-45%) was found to have no impact on HCV recurrence (P=0.47). Donor age (P=0.02) and cold ischaemia time (P=0.01) were found to increase the relative risk of HCV recurrence. The estimated risk of HCV recurrence increased by 23% for every 10-year increase in donor age. Similarly the risk of recurrence increased by 13% for every 1-h increase in cold ischaemia time.
  
  
  CONCLUSIONS
  Mild-moderate donor liver macrovesicular steatosis has no impact on HCV recurrence after liver transplantation for HCV-related cirrhosis. Cold ischaemia time and donor age increased the likelihood of HCV recurrence.
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, NE 68198-3285, USA. jbotha@unmc.edu
authors.forename: Jean F
authors.initials: JF
authors.lastname: Botha
authors.forename: Eric
authors.initials: E
authors.lastname: Thompson
authors.forename: Richard
authors.initials: R
authors.lastname: Gilroy
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Grant
authors.forename: Sandeep
authors.initials: S
authors.lastname: Mukherjee
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Lyden
authors.forename: Ira J
authors.initials: IJ
authors.lastname: Fox
authors.forename: Debra L
authors.initials: DL
authors.lastname: Sudan
authors.forename: Byers W
authors.initials: BW
authors.lastname: Shaw
authors.forename: Alan N
authors.initials: AN
authors.lastname: Langnas
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D050377:Cold Ischemia / Q000009:adverse effects; D018450:Disease Progression; D005234:Fatty Liver / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000150:complications* / Q000401:mortality / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000401:mortality / Q000601:surgery* / Q000821:virology; D016031:Liver Transplantation / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009329:Nebraska / Q000453:epidemiology; D016016:Proportional Hazards Models; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data; D016896:Treatment Outcome