title: Survival in patients with Child-Pugh class C cirrhosis: Analysis of the liver transplant registry in Japan.
abstract: OBJECTIVE
  To clarify the survival and prognostic factors in patients with Child-Turcotte-Pugh class C (CTP-C) cirrhosis.
  
  
  METHODS
  From all candidates for deceased donor liver transplantation in Japan between 2007 and 2015, 1014 adult patients with CTP-C cirrhosis were retrospectively enrolled in this study. The hazard ratio (HR) of factors associated with mortality was estimated by the Cox proportional hazard model. The survival probabilities were evaluated by Kaplan-Meier analysis and the log-rank test.
  
  
  RESULTS
  Median survival time of the entire cohort was 475 days. Univariate analysis identified age, CTP, Model for End-Stage Liver Disease (MELD) score, and primary biliary cholangitis (PBC) as significant variables associated with mortality and hepatitis B virus (HBV) infection as a close-to-significant variable. Multivariate analysis revealed that age-adjusted mortality risk increased by 59% and 12% per 1 score step up in CTP and MELD scores, respectively. The HRs for HBV infection and PBC were significant after adjustment for age and CTP score, and they showed a 26% lower risk and an 83% higher risk than hepatitis C virus (HCV) infection, respectively. After adjustment for age and MELD score, the HR was also significant for HBV infection, but lost statistical significance for PBC. The survival curves were well stratified by both CTP or MELD score and revealed significant difference in both HBV infection and PBC as compared to HCV infection.
  
  
  CONCLUSIONS
  In patients with CTP-C cirrhosis, CTP and MELD scores could well stratify the patients' survival, and HBV infection and PBC as etiologies have an impact on survival.
authors.affiliation: Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Izunokuni, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Genda
authors.affiliation: Department of Hepatology, East Shonan General Hospital, Kanagawa, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Ichida
authors.affiliation: Department of Gastroenterology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Shotaro
authors.initials: S
authors.lastname: Sakisaka
authors.affiliation: Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Tanaka
authors.affiliation: Department of Gastroenterology and Hepatology, Saitama Medical University, Saitama, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Mochida
authors.affiliation: Department of Gastroenterology, Yamagata University Faculty of Medicine, Yamagata, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Ueno
authors.affiliation: Division of Hepatology and Gastroenterology, Department of Pediatrics, Eastern Yokohama Hospital, Yokohama, Japan.
authors.forename: Ayano
authors.initials: A
authors.lastname: Inui
authors.affiliation: Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Egawa
authors.affiliation: Department of Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Umeshita
authors.affiliation: Department of Gastroentrologic and General Surgery, Asahikawa Medical University, Asahikawa, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Furukawa
authors.affiliation: Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Kawasaki
authors.affiliation: Department of Transplantation and Pediatric Surgery, Postgraduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Inomata
keywords: End-stage liver disease; hepatitis B virus; hepatocellular carcinoma; primary biliary cirrhosis