Liver retransplantation of patients with hepatitis C infection is associated with acceptable patient and graft survival.
Infection with hepatitis C virus (HCV) is the leading cause of liver transplantation (LT), while liver retransplantation (RT) for HCV is controversial as a result of concerns over poor outcomes. We sought to compare patient and graft survival after RT in patients with and without HCV. We performed a retrospective chart review of all patients undergoing RT at our center between February 1998 and April 2004. Indications for RT, HCV status, patient, and donor characteristics, laboratory values, and hospitalization status at RT were collected. A total of 108 patients (48 HCV and 60 non-HCV) underwent RT during the study period, with mean post-RT follow-up of 1,096 days (range, 0-2,888 days). Grafts from donors aged>60 years were used less frequently in HCV patients at RT (6%) compared with LT (47%), P<0.001. There was no difference between HCV vs. non-HCV patients in 1- and 3-year patient survival (respectively, 79% vs. 63%, and 71% vs. 63%) and graft survival (respectively, 67% vs. 66%, and 59% vs. 56%). Post-RT mortality and graft failure in HCV patients occurred within the first year in 89% of patients, and 83% were unrelated to HCV recurrence. We conclude that patients should not be excluded from consideration for retransplantation solely on the basis of a diagnosis of HCV.
Division of Gastroenterology , Department of Medicine, Mayo Clinic, Jacksonville, FL 32216, USA.
Marwan
M
Ghabril
Rolland C
RC
Dickson
Victor I
VI
Machicao
Jaime
J
Aranda-Michel
Andrew
A
Keaveny
Barry
B
Rosser
Hugo
H
Bonatti
Murli
M
Krishna
Maria
M
Yataco
Raj
R
Satyanarayana
Denise
D
Harnois
Winston
W
Hewitt
Darin D
DD
Willingham
Hani
H
Grewal
Christopher B
CB
Hughes
Justin
J
Nguyen
D000328:Adult; D000367:Age Factors; D000368:Aged; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000517:prevention & control / Q000821:virology; D006085:Graft Survival / Q000187:drug effects; D006526:Hepatitis C / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation; D008875:Middle Aged; D018579:Patient Selection; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D014019:Tissue Donors; D016896:Treatment Outcome
D007166:Immunosuppressive Agents