Reuters Health Information (2004-09-16): Liver transplant outcomes no worse for HCV-infected recipients
Liver transplant outcomes no worse for HCV-infected recipients
Last Updated: 2004-09-16 16:50:07 -0400 (Reuters Health)
NEW YORK (Reuters Health) - The first detailed report
of 10-year outcomes in liver transplant recipients with hepatitis C
virus (HCV) infection shows that these individuals fare just as well in
the long run as those undergoing liver transplantation for other
Recurrence of HCV infection, however, is an important cause of
mortality and graft loss and the impact of HCV infection increases with
HCV infection is "the most common indication for liver
transplantation in North America and Western Europe," Dr. Michael
Charlton from the Mayo Clinic in Rochester, Minnesota told Reuters
In the September issue of the journal Liver Transplantation, he and
colleagues present data for 165 HCV-infected liver transplant
recipients who were followed for up to 12 years after transplantation.
"Long-term outcomes, specifically patient and liver graft survival,
are as good for patients with [HCV] as they are for patients with
almost any other cause of liver disease," Dr. Charlton said. "This is
contrary to the findings of less complete and rigorous datasets."
Adjusted 10-year graft survival was 64% for HCV-infected individuals and 51% for uninfected individuals.
"We [also] found that some simple, readily identifiable variables
(higher pretransplant HCV RNA, negative CMV IgG serostatus, greater
recipient age and greater donor age) were associated with a high
likelihood of posttransplant death or graft failure," Dr. Charlton said.
These variables were incorporated in a formula that generated a
"risk score." A risk score above a certain level was "strongly
predictive of posttransplant death or graft loss," Dr. Charlton
For example, rates of mortality and graft loss at 1 and 5 years
posttransplant were 22% and 39%, respectively, among recipients with a
high pretransplant HCV score compared with 10% and 22% for recipients
with a lower risk score.
"The implications are that patients might be selected to minimize
the risk," Dr. Charlton explained. "For example, an older patient might
be provided with a recipient from a younger donor or HCV RNA levels
might be reduced with antiviral treatment prior to transplantation when
safe and practical."
Liver Transpl 2004;10:1120-1130.