Epidemiology

Donor age not linked to late mortality in transplanted cirrhotic HCV patients

Last Updated: 2005-03-30 16:44:36 -0400 (Reuters Health)

By Anthony J. Brown, MD

NEW YORK (Reuters Health) - In patients who undergo liver transplantation for hepatitis C virus (HCV)-related cirrhosis, donor age is inversely related to survival at 3 months, but has no effect on long-term survival, new research shows. Data from the same study indicate that maintenance azathioprine is linked to increased long-term survival.

Virtually all HCV-infected patients who undergo liver transplantation experience reinfection, but the severity of HCV recurrence is variable. In recent years, survival and HCV recurrence seems to be worsening among transplanted patients, the researchers explain in the April issue of Liver Transplantation.

Although donor age has been theorized to play a role, it remains unclear whether donor age has any effect on early or late mortality. To investigate, Dr. Andrew K. Burroughs, from the Royal Free Hospital in London, and colleagues analyzed data from 193 HCV cirrhotic patients who received a liver transplant from a cadaveric donor. The median follow-up period was 38 months.

As noted, donor age had no effect on survival after 3 months post-transplantation. The presence of hepatocellular carcinoma before transplantation as well as not using maintenance azathioprine were associated with decreased long-term survival.

Donor age also had no effect on the risk of severe fibrosis. Likewise, the year of transplantation did not influence this outcome, whereas hepatitis flare raised the risk and maintenance steroids decreased it.

"Donor age is probably not the most important factor determining the severity of HCV recurrence after liver transplantation," Dr. Burroughs told Reuters Health. "The results suggest that we should look at the impact of immunosuppression more carefully. And, in fact, trials are underway doing just that."

Liver Transpl 2005;11:386-395.