Post-liver transplant survival in hepatitis C patients is improving over time

Jacqueline G. O'Leary, Henry Randall, Nicholas Onaca, Linda Jennings, Göran B. Klintmalm, Gary L. Davis

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Outcomes after orthotopic liver transplantation for chronic hepatitis C have been reported to be worsening over the last 2 decades. We analyzed our center's experience over 15 years to identify trends in post-orthotopic liver transplantation survival in patients with and without hepatitis C virus infection. Patient survival and graft survival among adult primary orthotopic liver transplantation recipients who survived more than 90 days from January 1991 to June 2006 at the Baylor Regional Transplant Institute (n = 1901) were evaluated by Kaplan-Meier analysis. Those with or without hepatitis C virus infection were analyzed by era: era 1, 1991-1994 (n = 473); era 2, 1995-1998 (n = 421); era 3, 1999-2002 (n = 498); and era 4, 2003-2006 (n = 512). Differences in eras with disparate survivals were assessed by univariate and multivariable analysis. Overall, patient survival and graft survival were significantly lower among hepatitis C virus infection recipients compared to those without hepatitis C virus infection (P = 0.001). This difference was dependent on the era of transplantation, with progressive improvement in hepatitis C virus patient (P b 0.001) and graft (P b 0.001) survival in sequential eras. Several factors accounted for this improvement, notably better selection of hepatocellular carcinoma patients and fewer late cytomegalovirus infections. Improvement occurred despite an increase in the ages of both donors and recipients. In conclusion, posttransplant survival after orthotopic liver transplantation for chronic hepatitis C has improved significantly over the last 15 years despite demographic changes in patients and grafts that have been previously shown to impair survival. A major reason for this improvement is better selection of patients with concurrent hepatocellular carcinoma and fewer late cytomegalovirus infections, although other factors may play a role as well.

Original languageEnglish (US)
Pages (from-to)360-368
Number of pages9
JournalLiver Transplantation
Volume15
Issue number4
DOIs
StatePublished - Jun 29 2009

Fingerprint

Hepatitis C
Hepacivirus
Transplants
Virus Diseases
Survival
Liver
Liver Transplantation
Cytomegalovirus Infections
Graft Survival
Chronic Hepatitis C
Hepatocellular Carcinoma
Kaplan-Meier Estimate
Patient Selection
Transplantation
Demography
Tissue Donors

ASJC Scopus subject areas

  • Medicine(all)
  • Hepatology
  • Surgery
  • Transplantation

Cite this

O'Leary, J. G., Randall, H., Onaca, N., Jennings, L., Klintmalm, G. B., & Davis, G. L. (2009). Post-liver transplant survival in hepatitis C patients is improving over time. Liver Transplantation, 15(4), 360-368. https://doi.org/10.1002/lt.21691

Post-liver transplant survival in hepatitis C patients is improving over time. / O'Leary, Jacqueline G.; Randall, Henry; Onaca, Nicholas; Jennings, Linda; Klintmalm, Göran B.; Davis, Gary L.

In: Liver Transplantation, Vol. 15, No. 4, 29.06.2009, p. 360-368.

Research output: Contribution to journalArticle

O'Leary, JG, Randall, H, Onaca, N, Jennings, L, Klintmalm, GB & Davis, GL 2009, 'Post-liver transplant survival in hepatitis C patients is improving over time', Liver Transplantation, vol. 15, no. 4, pp. 360-368. https://doi.org/10.1002/lt.21691
O'Leary, Jacqueline G. ; Randall, Henry ; Onaca, Nicholas ; Jennings, Linda ; Klintmalm, Göran B. ; Davis, Gary L. / Post-liver transplant survival in hepatitis C patients is improving over time. In: Liver Transplantation. 2009 ; Vol. 15, No. 4. pp. 360-368.
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