Outcome after liver transplantation for cirrhosis due to alcohol and Hepatitis C: Comparison to alcoholic cirrhosis and Hepatitis C cirrhosis

Ashwani K. Singal, Bashar S. Hmoud, Praveen Guturu, Yong Fang Kuo

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19 Citations (Scopus)

Abstract

BACKGROUND AND AIM: Data on outcome of patients after liver transplantation (LT) for cirrhosis due to hepatitis C virus (HCV+) alcohol are limited. METHODS AND RESULTS: Analysis from United Network for Organ sharing data set (1991 to 2010) for cirrhotics with first LT for HCV (group I, N=17,722), alcohol or alcoholic cirrhosis (AC; group II, N=9617), and alcohol+HCV (group III, N=6822). Five-year graft and patient survival for group III were similar to group I (73% vs. 69%; P=0.33 and 76% vs. 76%; P=0.87) and worse than group II (70% vs. 74%; P<0.0001 and 76% vs. 79%; P<0.0001). Cox regression analysis adjusted for recipient and donor characteristics showed (a) graft survival for group III similar to group I [hazard ratio (HR) 1.03 (95% confidence interval (CI), 0.97-1.09)] and worse than group II [HR 1.27 (95% CI, 1.19-1.35)] and (b) patient survival for group III worse than both groups I [HR 1.09 (95% CI, 1.02-1.15)] and II [HR 1.27 (95% CI, 1.19-1.36)]. In group III, graft failure was common for graft and patient loss and de novo malignancy more common compared with group I. CONCLUSIONS: Patients undergoing LT for cirrhosis due to combined alcohol and HCV have (a) graft survival similar to patients with HCV cirrhosis and worse than AC and (b) worse patient survival compared with AC and HCV cirrhosis. Better strategies for anti-HCV treatment and screening for tumors are needed for patients undergoing LT for combined alcohol and HCV.

Original languageEnglish (US)
Pages (from-to)727-733
Number of pages7
JournalJournal of Clinical Gastroenterology
Volume47
Issue number8
DOIs
StatePublished - Sep 2013

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Alcoholic Hepatitis
Alcoholic Liver Cirrhosis
Hepatitis C
Liver Cirrhosis
Liver Transplantation
Fibrosis
Alcohols
Graft Survival
Confidence Intervals
Transplants
Survival
Hepacivirus
Neoplasms
Regression Analysis
Tissue Donors

Keywords

  • De novo malignancy
  • Graft survival
  • Mortality
  • Recurrent hepatitis
  • UNOS

ASJC Scopus subject areas

  • Gastroenterology

Cite this

@article{b72f1ef276604b419be084dea150c2da,
title = "Outcome after liver transplantation for cirrhosis due to alcohol and Hepatitis C: Comparison to alcoholic cirrhosis and Hepatitis C cirrhosis",
abstract = "BACKGROUND AND AIM: Data on outcome of patients after liver transplantation (LT) for cirrhosis due to hepatitis C virus (HCV+) alcohol are limited. METHODS AND RESULTS: Analysis from United Network for Organ sharing data set (1991 to 2010) for cirrhotics with first LT for HCV (group I, N=17,722), alcohol or alcoholic cirrhosis (AC; group II, N=9617), and alcohol+HCV (group III, N=6822). Five-year graft and patient survival for group III were similar to group I (73{\%} vs. 69{\%}; P=0.33 and 76{\%} vs. 76{\%}; P=0.87) and worse than group II (70{\%} vs. 74{\%}; P<0.0001 and 76{\%} vs. 79{\%}; P<0.0001). Cox regression analysis adjusted for recipient and donor characteristics showed (a) graft survival for group III similar to group I [hazard ratio (HR) 1.03 (95{\%} confidence interval (CI), 0.97-1.09)] and worse than group II [HR 1.27 (95{\%} CI, 1.19-1.35)] and (b) patient survival for group III worse than both groups I [HR 1.09 (95{\%} CI, 1.02-1.15)] and II [HR 1.27 (95{\%} CI, 1.19-1.36)]. In group III, graft failure was common for graft and patient loss and de novo malignancy more common compared with group I. CONCLUSIONS: Patients undergoing LT for cirrhosis due to combined alcohol and HCV have (a) graft survival similar to patients with HCV cirrhosis and worse than AC and (b) worse patient survival compared with AC and HCV cirrhosis. Better strategies for anti-HCV treatment and screening for tumors are needed for patients undergoing LT for combined alcohol and HCV.",
keywords = "De novo malignancy, Graft survival, Mortality, Recurrent hepatitis, UNOS",
author = "Singal, {Ashwani K.} and Hmoud, {Bashar S.} and Praveen Guturu and Kuo, {Yong Fang}",
year = "2013",
month = "9",
doi = "10.1097/MCG.0b013e318294148d",
language = "English (US)",
volume = "47",
pages = "727--733",
journal = "Journal of Clinical Gastroenterology",
issn = "0192-0790",
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TY - JOUR

T1 - Outcome after liver transplantation for cirrhosis due to alcohol and Hepatitis C

T2 - Comparison to alcoholic cirrhosis and Hepatitis C cirrhosis

AU - Singal, Ashwani K.

AU - Hmoud, Bashar S.

AU - Guturu, Praveen

AU - Kuo, Yong Fang

PY - 2013/9

Y1 - 2013/9

N2 - BACKGROUND AND AIM: Data on outcome of patients after liver transplantation (LT) for cirrhosis due to hepatitis C virus (HCV+) alcohol are limited. METHODS AND RESULTS: Analysis from United Network for Organ sharing data set (1991 to 2010) for cirrhotics with first LT for HCV (group I, N=17,722), alcohol or alcoholic cirrhosis (AC; group II, N=9617), and alcohol+HCV (group III, N=6822). Five-year graft and patient survival for group III were similar to group I (73% vs. 69%; P=0.33 and 76% vs. 76%; P=0.87) and worse than group II (70% vs. 74%; P<0.0001 and 76% vs. 79%; P<0.0001). Cox regression analysis adjusted for recipient and donor characteristics showed (a) graft survival for group III similar to group I [hazard ratio (HR) 1.03 (95% confidence interval (CI), 0.97-1.09)] and worse than group II [HR 1.27 (95% CI, 1.19-1.35)] and (b) patient survival for group III worse than both groups I [HR 1.09 (95% CI, 1.02-1.15)] and II [HR 1.27 (95% CI, 1.19-1.36)]. In group III, graft failure was common for graft and patient loss and de novo malignancy more common compared with group I. CONCLUSIONS: Patients undergoing LT for cirrhosis due to combined alcohol and HCV have (a) graft survival similar to patients with HCV cirrhosis and worse than AC and (b) worse patient survival compared with AC and HCV cirrhosis. Better strategies for anti-HCV treatment and screening for tumors are needed for patients undergoing LT for combined alcohol and HCV.

AB - BACKGROUND AND AIM: Data on outcome of patients after liver transplantation (LT) for cirrhosis due to hepatitis C virus (HCV+) alcohol are limited. METHODS AND RESULTS: Analysis from United Network for Organ sharing data set (1991 to 2010) for cirrhotics with first LT for HCV (group I, N=17,722), alcohol or alcoholic cirrhosis (AC; group II, N=9617), and alcohol+HCV (group III, N=6822). Five-year graft and patient survival for group III were similar to group I (73% vs. 69%; P=0.33 and 76% vs. 76%; P=0.87) and worse than group II (70% vs. 74%; P<0.0001 and 76% vs. 79%; P<0.0001). Cox regression analysis adjusted for recipient and donor characteristics showed (a) graft survival for group III similar to group I [hazard ratio (HR) 1.03 (95% confidence interval (CI), 0.97-1.09)] and worse than group II [HR 1.27 (95% CI, 1.19-1.35)] and (b) patient survival for group III worse than both groups I [HR 1.09 (95% CI, 1.02-1.15)] and II [HR 1.27 (95% CI, 1.19-1.36)]. In group III, graft failure was common for graft and patient loss and de novo malignancy more common compared with group I. CONCLUSIONS: Patients undergoing LT for cirrhosis due to combined alcohol and HCV have (a) graft survival similar to patients with HCV cirrhosis and worse than AC and (b) worse patient survival compared with AC and HCV cirrhosis. Better strategies for anti-HCV treatment and screening for tumors are needed for patients undergoing LT for combined alcohol and HCV.

KW - De novo malignancy

KW - Graft survival

KW - Mortality

KW - Recurrent hepatitis

KW - UNOS

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U2 - 10.1097/MCG.0b013e318294148d

DO - 10.1097/MCG.0b013e318294148d

M3 - Article

C2 - 23751845

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VL - 47

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JO - Journal of Clinical Gastroenterology

JF - Journal of Clinical Gastroenterology

SN - 0192-0790

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