PMID- 14742986
OWN - NLM
STAT- MEDLINE
DCOM- 20040227
LR  - 20220409
IS  - 0041-1337 (Print)
IS  - 0041-1337 (Linking)
VI  - 77
IP  - 2
DP  - 2004 Jan 27
TI  - Long-term outcome of liver transplants for chronic hepatitis C: a 10-year 
      follow-up.
PG  - 226-31
AB  - BACKGROUND: Recurrence of hepatitis C (HCV) infection after orthotopic liver 
      transplantation (OLT) in HCV-positive patients is almost universal. Severity of 
      graft hepatitis increases during the long-term follow-up, and up to 30% of 
      patients develop severe graft hepatitis and cirrhosis. However, there are still 
      no clear predictors for severe recurrence. The aim of this study was to examine 
      the 10-year outcome and risk factors for graft failure caused by HCV recurrence. 
      METHODS: In a prospective analysis, 234 OLTs in 209 HCV-positive patients with a 
      median age of 53 years were analyzed. Immunosuppression was based on cyclosporine 
      A or tacrolimus in different protocols. Predictors for outcome were genotype, 
      viremia, donor variables, recipient demographics, postoperative 
      immunosuppression, and human leukocyte antigen (HLA) compatibilities. RESULTS: 
      Actuarial 5-, and 10-year patient survival was 75.8% and 68.8%. Eighteen of 209 
      (8.7%) patients died because of HCV recurrence, which was responsible for 35.9% 
      of the total 53 deaths. Significant risk factors for HCV-related graft failure in 
      an univariate analysis were multiple steroid pulses, use of OKT3, and donor age 
      greater than 40. However, in a multivariate analysis, multiple rejection 
      treatments with steroids and OKT3 treatment proved to be significantly associated 
      with HCV-related graft loss. CONCLUSIONS: The analysis of causes leading to graft 
      failure in patients with HCV showed that HCV recurrence is responsible for one of 
      three deaths in HCV-positive patients. Rejection treatment contributed 
      significantly to an enhanced risk for HCV-related graft loss. New antiviral 
      treatments, as well as adapted immunosuppressive protocols, will be necessary to 
      further improve the outcome of HCV-positive patients after liver transplantation.
FAU - Neumann, Ulf P
AU  - Neumann UP
AD  - Klinik fur Allgemein-, Viszeral-, und Transplantationschirurgie, 
      Universitatsklinikum Charite, Campus Virchow-Klinikum, Humboldt-Universitat, 
      Berlin, Germany. ulf.neumann@charite.de
FAU - Berg, Thomas
AU  - Berg T
FAU - Bahra, Marcus
AU  - Bahra M
FAU - Puhl, Gero
AU  - Puhl G
FAU - Guckelberger, Olaf
AU  - Guckelberger O
FAU - Langrehr, Jan M
AU  - Langrehr JM
FAU - Neuhaus, Peter
AU  - Neuhaus P
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (Immunosuppressive Agents)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Analysis of Variance
MH  - Child
MH  - Creatinine/blood
MH  - Drug Therapy, Combination
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Rejection/*epidemiology
MH  - Graft Survival/immunology/physiology
MH  - Hepatitis C, Chronic/*surgery
MH  - Histocompatibility Testing
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Liver Transplantation/immunology/mortality/*physiology
MH  - Male
MH  - Middle Aged
MH  - Survival Analysis
MH  - Time Factors
MH  - Tissue Donors
MH  - Treatment Outcome
EDAT- 2004/01/27 05:00
MHDA- 2004/02/28 05:00
CRDT- 2004/01/27 05:00
PHST- 2004/01/27 05:00 [pubmed]
PHST- 2004/02/28 05:00 [medline]
PHST- 2004/01/27 05:00 [entrez]
AID - 00007890-200401270-00012 [pii]
AID - 10.1097/01.TP.0000101738.27552.9D [doi]
PST - ppublish
SO  - Transplantation. 2004 Jan 27;77(2):226-31. doi: 
      10.1097/01.TP.0000101738.27552.9D.