Survival of liver transplant recipients with hemochromatosis in the United States.
OBJECTIVE
Earlier studies have suggested that patients with hemochromatosis have poor post-transplantation survival. We aimed to compare patients with hemochromatosis to those with other causes of liver disease with regard to post-transplantation survival.


METHODS
We compared the post-transplant survival of patients with and without hemochromatosis using data provided by the United Network for Organ Sharing on 50,306 adult, cadaveric liver transplantations performed in the United States between January 1, 1990, and July 18, 2006.


RESULTS
During 1990-1996, the post-transplantation survival of patients with hemochromatosis (n = 177) at 1 year (79.1%), 3 years (71.8%), and 5 years (64.6%) was lower than the average 1-year (86.4%), 3-year (79.5%), and 5-year (73.8%) survival of all other transplant recipients (hazard ratio for death, 1.38; 95% confidence interval [CI], 1.12-1.71). In contrast, during 1997-2006, patients with hemochromatosis (n = 217) had excellent 1-year (86.1%), 3-year (80.8%), and 5-year (77.3%) post-transplantation survival, which was not different from the 1-year (88.4%), 3-year (80.3%), and 5-year (74.0%) post-transplantation survival of all other transplant recipients (hazard ratio for death, 0.89; 95% CI, 0.65-1.22). Adjustment for donor and recipient characteristics did not substantially change these results. Compared with recipients without hemochromatosis, those with hemochromatosis were more likely to die of cardiovascular diseases and less likely to die as a result of graft failure.


CONCLUSIONS
The post-transplantation survival of patients with hemochromatosis, which was previously reported to be poor, has been excellent in the United States during the past 10 years.
Division of Gastroenterology, Department of Medicine Veterans Affairs Puget Sound Health Care System and University of Washington, Seattle, Washington 98108, USA.
Lei
L
Yu
George N
GN
Ioannou
D000328:Adult; D002318:Cardiovascular Diseases / Q000401:mortality; D005260:Female; D006085:Graft Survival; D006432:Hemochromatosis / Q000150:complications* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008107:Liver Diseases / Q000209:etiology / Q000401:mortality* / Q000601:surgery; D016031:Liver Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011159:Population Surveillance; D016016:Proportional Hazards Models; D012042:Registries / Q000706:statistics & numerical data; D018570:Risk Assessment; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology