title: Impact of human T-cell leukemia virus type 1 on living donor liver transplantation: a multi-center study in Japan.
abstract: BACKGROUND
  The natural history of human T-cell leukemia virus type 1 (HTLV-1), which causes adult T-cell leukemia (ATL) or HTLV-1 associated myelopathy, after liver transplantation is unclear.
  
  
  METHODS
  We conducted a nationwide survey to investigate the impact of HTLV-1 status on living donor liver transplantation (LDLT) in Japan. We analyzed the cases of 82 HTLV-1-positive recipients and six HTLV-1-negative-before-LDLT recipients who received a hepatic graft from HTLV-1-positive donors.
  
  
  RESULTS
  Adult T-cell leukemia developed in five recipients who ultimately died. Of these five, two received grafts from HTLV-1-positive donors and three from HTLV-1-negative donors. The 1-, 3-, and 5-year ATL development rates were 4.5%, 6.5%, and 9.2%, respectively. Fulminant hepatic failure as a pre-transplant diagnosis was identified as an independent risk factor for ATL development (P = 0.001). The 1-, 3-, and 5-year survival rates for HTLV-1-positive recipients who received grafts from HTLV-1-negative donors were 79.9%, 66.1%, and 66.1%, and from HTLV-1-positive donors were 83.3%, 83.3%, and 60.8%, respectively. The 1-year survival rate for HTLV-1-negative recipients who received grafts from HTLV-1-positive donors was 33.3%.
  
  
  CONCLUSIONS
  Fulminant hepatic failure is an independent risk factor for ATL development in HTLV-1-positive recipients. Grafts from HTLV-1-positive living donors can be transplanted into selected patients.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Yoshizumi
authors.affiliation: The Study Group of the Japanese Society of Hepato-biliary-Pancreatic Surgery and Japanese Liver Transplantation Society, Tokyo, Japan.
authors.forename: Yasutsugu
authors.initials: Y
authors.lastname: Takada
authors.affiliation: The Study Group of the Japanese Society of Hepato-biliary-Pancreatic Surgery and Japanese Liver Transplantation Society, Tokyo, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
authors.affiliation: The Study Group of the Japanese Society of Hepato-biliary-Pancreatic Surgery and Japanese Liver Transplantation Society, Tokyo, Japan.
authors.forename: Toshimi
authors.initials: T
authors.lastname: Kaido
authors.affiliation: The Study Group of the Japanese Society of Hepato-biliary-Pancreatic Surgery and Japanese Liver Transplantation Society, Tokyo, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hidaka
authors.affiliation: The Study Group of the Japanese Society of Hepato-biliary-Pancreatic Surgery and Japanese Liver Transplantation Society, Tokyo, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Honda
authors.affiliation: The Study Group of the Japanese Society of Hepato-biliary-Pancreatic Surgery and Japanese Liver Transplantation Society, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ito
authors.affiliation: The Study Group of the Japanese Society of Hepato-biliary-Pancreatic Surgery and Japanese Liver Transplantation Society, Tokyo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Shinoda
authors.affiliation: The Study Group of the Japanese Society of Hepato-biliary-Pancreatic Surgery and Japanese Liver Transplantation Society, Tokyo, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohdan
authors.affiliation: The Study Group of the Japanese Society of Hepato-biliary-Pancreatic Surgery and Japanese Liver Transplantation Society, Tokyo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kawagishi
authors.affiliation: The Study Group of the Japanese Society of Hepato-biliary-Pancreatic Surgery and Japanese Liver Transplantation Society, Tokyo, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sugawara
authors.affiliation: The Study Group of the Japanese Society of Hepato-biliary-Pancreatic Surgery and Japanese Liver Transplantation Society, Tokyo, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ogura
authors.affiliation: The Study Group of the Japanese Society of Hepato-biliary-Pancreatic Surgery and Japanese Liver Transplantation Society, Tokyo, Japan.
authors.forename: Mureo
authors.initials: M
authors.lastname: Kasahara
authors.affiliation: The Study Group of the Japanese Society of Hepato-biliary-Pancreatic Surgery and Japanese Liver Transplantation Society, Tokyo, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Kubo
authors.affiliation: The Study Group of the Japanese Society of Hepato-biliary-Pancreatic Surgery and Japanese Liver Transplantation Society, Tokyo, Japan.
authors.forename: Akinobu
authors.initials: A
authors.lastname: Taketomi
authors.affiliation: Clinical Research Center, Shikoku Cancer Center, Matsuyama, Japan.
authors.forename: Natsumi
authors.initials: N
authors.lastname: Yamashita
authors.affiliation: The Study Group of the Japanese Society of Hepato-biliary-Pancreatic Surgery and Japanese Liver Transplantation Society, Tokyo, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
authors.affiliation: The Study Group of the Japanese Society of Hepato-biliary-Pancreatic Surgery and Japanese Liver Transplantation Society, Tokyo, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamaue
authors.affiliation: The Study Group of the Japanese Society of Hepato-biliary-Pancreatic Surgery and Japanese Liver Transplantation Society, Tokyo, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
authors.affiliation: The Study Group of the Japanese Society of Hepato-biliary-Pancreatic Surgery and Japanese Liver Transplantation Society, Tokyo, Japan.
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Takada
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000821:virology*; D006085:Graft Survival; D015490:HTLV-I Infections / Q000175:diagnosis* / Q000453:epidemiology; D006785:Hospitals, University; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D007564:Japan; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D018579:Patient Selection; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D066027:Transplant Recipients; D055815:Young Adult
keywords: Adult T-cell leukemia; Human T-cell leukemia virus type 1; Living donor liver transplantation