Excellent liver retransplantation outcomes in hepatitis C-infected recipients

Clin Transplant. 2013 Jul-Aug;27(4):E512-20. doi: 10.1111/ctr.12182. Epub 2013 Jul 16.

Abstract

Survival outcomes for liver retransplantation (LRTx) after graft loss in HCV patients (HCV-LRTx) are generally considered inferior to those after non-HCV-LRTx. Between January 1, 2005 and June 30, 2011, our center performed 663 LTx, including 116 (17.5%) LRTx, 41 (35.3%) of which were more than 90 d after the LTx. Twenty-nine (70.7%) LRTx were performed in HCV antibody-positive individuals. We compared patient demographics, baseline characteristics and outcomes of our HCV-LRTx group with the HCV-LRTx patients from the most recent OPTN database covering the same time period. Our Kaplan-Meier HCV-LRTx one-, three-, and five-yr HCV-LRTx patient survival rates were 86.2%, 79.0%, and 72.4%, respectively compared with the OPTN one-, three-, and five-yr HCV-LRTx survival rates of 73.3%, 59.0%, and 51.3% respectively. Likewise, our graft survival rates were higher than OPTN rates at all time points studied. We performed a higher percentage of HCV-LRTx as simultaneous liver/kidney transplants (SLK) (37.9% vs. 21.8%) and recorded shorter warm (30 ± 4 vs. 45 ± 23 min) and cold ischemic times (5:44 ± 1:53 vs. 7:36 ± 3:12 h:min).

Conclusion: In our experience, HCV-LRTx patient and graft survival rates are comparable to LTx survival rates and are higher than the rates described by OPTN.

Keywords: HCV recurrence; cold ischemic time; retransplantation; survival rates; warm ischemic time.

Publication types

  • Clinical Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Graft Rejection / etiology
  • Graft Rejection / prevention & control
  • Graft Survival
  • Hepacivirus / pathogenicity*
  • Hepatitis C / etiology
  • Hepatitis C / mortality
  • Hepatitis C / surgery*
  • Humans
  • Liver Failure / complications
  • Liver Failure / surgery
  • Liver Failure / virology*
  • Liver Transplantation / mortality*
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Prognosis
  • Reoperation*
  • Retrospective Studies
  • Survival Rate