title: Hepatitis C impairs survival following liver transplantation irrespective of concomitant hepatocellular carcinoma.
abstract: OBJECTIVE
  Liver transplantation (LTX) is the only curative treatment for end-stage liver disease caused by hepatitis C (HCV). Hepatocellular carcinoma (HCC) is common in patients with HCV cirrhosis.
  
  
  METHODS
  Two hundred and eighty-two HCV patients listed for LTX in the Nordic countries in a 17-year period were included. For comparison a group of patients with non-viral chronic liver disease (n=1552) was used.
  
  
  RESULTS
  Two hundred and fifty-three (90%) patients received a first liver allograft. HCC was found in 38% of the explanted livers. Survival at 1, 3 and 5years was 82%, 69% and 61% vs. 85%, 80% and 76% for the comparison group (p<0.0001), this survival difference was also evident when excluding patients with HCC (p=0.007). HCV patients with HCC had 1, 3 and 5year survival of 73%, 52% and 46% compared with 88%, 80% and 71% for the HCV patients without HCC (p=0.0005). In an intention-to-treat analysis (from time of acceptance to the waiting list) HCV was also associated with an impaired survival.
  
  
  CONCLUSIONS
  HCV cirrhosis, which is now also an important indication for LTX in the Nordic countries, and significantly impairs survival following LTX. Concomitant HCC and donor age are the two most important factors contributing to an impaired survival.
authors: Department of Medicine, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway.
authors: Espen
authors: E
authors: Melum
authors: Styrbjörn
authors: S
authors: Friman
authors: Kristian
authors: K
authors: Bjøro
authors: Allan
authors: A
authors: Rasmussen
authors: Helena
authors: H
authors: Isoniemi
authors: Henrik
authors: H
authors: Gjertsen
authors: Lars
authors: L
authors: Bäckman
authors: Antti
authors: A
authors: Oksanen
authors: Michael
authors: M
authors: Olausson
authors: Frans F
authors: FF
authors: Duraj
authors: Bo-Göran
authors: BG
authors: Ericzon
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000401:mortality*; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D006526:Hepatitis C / Q000150:complications* / Q000209:etiology / Q000401:mortality*; D006801:Humans; D008103:Liver Cirrhosis; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D015996:Survival Rate