Retrospective cohort study of liver transplantation in the United Kingdom between 1994 and 2010: the impact of hepatitis C infection.
BACKGROUND
Liver transplantation is an important and established treatment option for chronic hepatitis C virus (HCV) related end-stage liver disease (HCV-related ESLD). This study describes trends in elective liver transplantation among persons with HCV-related ESLD.


METHODS
Retrospective cohort.


METHODS
Analyses of United Kingdom (UK) Transplant Registry data for the period 1994 to 2010, with follow-up information extending to 2011.


RESULTS
Annual registrations for liver transplantation increased linearly and alcoholic liver cirrhosis (2075, 24%) and HCV-related ESLD (1213, 14%) were the most common indications. HCV-related ESLD patients were mainly aged 40-49 years (32%) and 50-59 years (43%); males (76%); and of white ethnicity (74%). Overall, 75% (956/1213) received a liver transplant with a linear increase over the period (OR 1.11, 95% CI 1.08, 1.13). Pre transplant mortality was unchanged (adjusted OR 1.0, 95% CI 0.96, 1.05) and post-transplant mortality decreased in both HCV-related (adjusted OR 0.77, 95% CI 0.68, 0.88) and non-HCV-related ESLD (adjusted OR 0.82, 95% CI 0.75, 0.89) patients.


CONCLUSIONS
The increase in demand for and receipt of liver transplants among persons with HCV-related ESLD requires coordinated efforts to increase not only organ donation, but investment in HCV prevention programmes and improved access to hepatitis C treatment services.
Field Epidemiology Service, Public Health England, UK. Electronic address: obaghe.edeghere@phe.gov.uk.
O
O
Edeghere
Statistics, Modelling and Economics Department, Centre for Infectious Disease Surveillance and Control, Public Health England, UK.
N Q
NQ
Verlander
Chelsea and West Minister NHS Trust, UK.
J
J
Aboulhab
Immunisation, Hepatitis and Blood Safety Department, Centre for Infectious Disease Surveillance and Control, Public Health England, UK.
A
A
Costella
Immunisation, Hepatitis and Blood Safety Department, Centre for Infectious Disease Surveillance and Control, Public Health England, UK.
H E
HE
Harris
Immunisation, Hepatitis and Blood Safety Department, Centre for Infectious Disease Surveillance and Control, Public Health England, UK.
M A
MA
Balogun
Immunisation, Hepatitis and Blood Safety Department, Centre for Infectious Disease Surveillance and Control, Public Health England, UK.
M E
ME
Ramsay
D000293:Adolescent; D000328:Adult; D000368:Aged; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D058625:End Stage Liver Disease / Q000601:surgery* / Q000821:virology*; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D016031:Liver Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D006113:United Kingdom; D055815:Young Adult
Clinical outcome; End stage liver disease; Hepatitis C; Liver cirrhosis; Liver transplantation; Retrospective studies