The impact of hepatitis C and biliary complications on patient and graft survival following liver transplantation

E. C. Verna, E. De Martin, P. Burra, D. Neri, P. J. Gaglio, J. C. Emond, R. S. Brown

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Recurrent hepatitis C (HCV) and biliary complications (BC) are major causes of post liver transplant morbidity and mortality. The impact of these complications may be additive or synergistic. We performed a retrospective cohort study to analyze the effects of HCV and BC on all patients transplanted at two institutions over 6 years. BC was defined by imaging findings in the setting of abnormal liver function tests that required intervention. The primary outcomes were graft and patient survival over a mean 3.4 years. 709 patients (619 deceased, 90 living donor) were included, 337 with HCV and 372 without. BC was diagnosed more frequently in patients with HCV, 26% versus 18% (p = 0.008). One-year and overall patient and graft survival were significantly lower in patients with HCV, but BC impacted only 1-year graft survival. The combination of BC and HCV had no additional impact on survival or fibrosis rates on 1-year protocol biopsies. Multivariate analysis revealed HCV (HR 2.1) and HCC (HR 1.9) to be independent predictors of mortality. Since BC are diagnosed more frequently in HCV patients and only affect early graft loss, it is likely that recurrent HCV rather than BC accounts for the majority of adverse graft outcomes.

Original languageEnglish (US)
Pages (from-to)1398-1405
Number of pages8
JournalAmerican Journal of Transplantation
Volume9
Issue number6
DOIs
StatePublished - Jun 2009
Externally publishedYes

Fingerprint

Graft Survival
Hepatitis C
Liver Transplantation
Transplants
Mortality
Living Donors
Liver Function Tests
Fibrosis
Cohort Studies
Multivariate Analysis
Retrospective Studies
Morbidity
Biopsy
Survival
Liver

Keywords

  • Biliary complication
  • Liver transplant
  • Recurrent hepatitis C virus

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)

Cite this

The impact of hepatitis C and biliary complications on patient and graft survival following liver transplantation. / Verna, E. C.; De Martin, E.; Burra, P.; Neri, D.; Gaglio, P. J.; Emond, J. C.; Brown, R. S.

In: American Journal of Transplantation, Vol. 9, No. 6, 06.2009, p. 1398-1405.

Research output: Contribution to journalArticle

Verna, E. C. ; De Martin, E. ; Burra, P. ; Neri, D. ; Gaglio, P. J. ; Emond, J. C. ; Brown, R. S. / The impact of hepatitis C and biliary complications on patient and graft survival following liver transplantation. In: American Journal of Transplantation. 2009 ; Vol. 9, No. 6. pp. 1398-1405.
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