title: Hepatic preservation injury: severity of hepatitis C recurrence and survival after liver transplantation.
abstract: BACKGROUND
  Preservation injury in the HCV liver transplant population has been reported to correlate with poorer survival outcomes compared to preservation injury in the non-HCV liver transplant population. However, determinants of progression to cirrhosis in HCV infection remain poorly defined in this population.
  
  
  OBJECTIVE
  This study aimed to determine if the presence and severity of preservation injury impact the acceleration of HCV recurrence and survival after liver transplant.
  
  
  METHODS
  We retrospectively reviewed liver transplant HCV patients over a 10-year period. Biopsies from postoperative day 7 were assessed for preservation injury and 4- and 12-month biopsies were assessed for fibrosis. Patients with Ishak fibrosis >0.8 Units/year were considered rapid fibrosers.
  
  
  RESULTS
  Our study group consisted of 255 patients. The mean age was 49.3 years old, 180 (70.6 %) were male, and 221 (86.7 %) were Caucasian. The incidence of preservation injury on the 7-day biopsy was 69.0 %. A strong correlation between postoperative peak AST within the first week and preservation injury was found. The overall prevalence of rapid fibrosers at 4 months, 1 and 2 years was 47.4, 75.2, and 58.9 %, respectively. The prevalence of rapid fibrosers at 4 months, 1 and 2 years between patients with or without preservation injury was not statistically significant (p = 0.39, p = 0.46, and p = 0.53, respectively). No differences were seen between patients with and without PI in terms of patient and graft survival.
  
  
  CONCLUSIONS
  In this study, the presence and severity of preservation injury were not associated with development of rapid HCV recurrence or worsening in survival.
authors.affiliation: Division of Gastroenterology and Hepatology, The Ohio State University Medical Center, 395W 12th Ave, Suite 200, Columbus, OH 43210, USA. Anthony.Michaels@osumc.edu
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Michaels
authors.forename: Renumathy
authors.initials: R
authors.lastname: Dhanasekaran
authors.forename: David P
authors.initials: DP
authors.lastname: Foley
authors.forename: Ahmad
authors.initials: A
authors.lastname: Alkhasawneh
authors.forename: Lisa
authors.initials: L
authors.lastname: Dixon
authors.forename: Consuelo
authors.initials: C
authors.lastname: Soldevila-Pico
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Morelli
authors.forename: Roniel
authors.initials: R
authors.lastname: Cabrera
authors.forename: Virginia C
authors.initials: VC
authors.lastname: Clark
authors.forename: Roberto J
authors.initials: RJ
authors.lastname: Firpi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005431:Florida / Q000453:epidemiology; D006526:Hepatitis C / Q000209:etiology* / Q000401:mortality; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000209:etiology; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation / Q000009:adverse effects* / Q000401:mortality; D012008:Recurrence; D012189:Retrospective Studies; D055815:Young Adult