title: Hepatitis C virus-related cirrhosis as a significant mortality factor in intention-to-treat analysis in liver transplantation.
abstract: BACKGROUND
  Liver transplantation represents the gold standard for the treatment of chronic liver disease. The whole transplantation process was assessed using an intention-to-treat analysis and considering patients from the time of their inclusion on the list and throughout lengthy follow-up.
  
  
  METHODS
  From January 1, 1999 to June 1, 2004, 373 adults joined the waiting list for liver transplantation at our institution. The main variables analyzed were: age, gender, etiology, Model for End-stage Liver Disease score, Child-Pugh class, United Network for Organ Sharing (UNOS) status. Global survival was evaluated using intention-to-treat analysis from the time of patient inclusion in the list to the end of their late follow-up.
  
  
  RESULTS
  The median waiting time was 20 months (range 0.1 to 70.2). By univariate analysis, the variables significantly influencing survival when patients joined the waiting list were: encephalopathy; ascites, poor nutritional status, Child-Pugh class C, UNOS 2, hepatitis C virus (HCV) and bilirubin > 2 mg/dL. By multivariate analysis, only HCV-related cirrhosis emerged as having an independent prognostic value. By intention-to-treat analysis, the 5-year survival rate was 67% and 79% for HCV-positive and HCV-negative patients, respectively (P = .0003).
  
  
  CONCLUSIONS
  HCV-related cirrhosis is an independent prognostic factor for survival according to an intention-to-treat analysis. Different inclusion criteria or treatments while on the waiting list and after transplantation need to be considered in the future for HCV-positive patients.
authors: Unità di Chirurgia Epatobiliare e Trapianto Epatico, Dipartimento assistenziale di Chirugia Generale e Trapianti d'Organo, Università, Azienda Ospedaliera di Padova, Padova, Italy. enrico.gringeri@unipd.it
authors: E
authors: E
authors: Gringeri
authors: A
authors: A
authors: Vitale
authors: A
authors: A
authors: Brolese
authors: G
authors: G
authors: Zanus
authors: P
authors: P
authors: Boccagni
authors: D
authors: D
authors: Neri
authors: M
authors: M
authors: Valmasoni
authors: F
authors: F
authors: D'Amico
authors: F A
authors: FA
authors: Ciarleglio
authors: A
authors: A
authors: Carraro
authors: A
authors: A
authors: Pauletto
authors: P
authors: P
authors: Violi
authors: D
authors: D
authors: Bassi
authors: F
authors: F
authors: D'Amico
authors: D F
authors: DF
authors: D'Amico
authors: U
authors: U
authors: Cillo
mesh_terms: D000328:Adult; D005260:Female; D006526:Hepatitis C / Q000150:complications* / Q000401:mortality; D006801:Humans; D033182:Intention; D008103:Liver Cirrhosis / Q000401:mortality / Q000601:surgery* / Q000821:virology*; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014850:Waiting Lists