Outcomes in hepatitis C virus-infected recipients of living donor vs. deceased donor liver transplantation

Norah A. Terrault, Mitchell L. Shiffman, Anna S F Lok, Sammy Saab, Lan Tong, Robert S. Brown, Gregory T. Everson, K. Rajender Reddy, Jeffrey Fair, Laura M. Kulik, Timothy L. Pruett, Leonard B. Seeff

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Abstract

In this retrospective study of hepatitis C virus (HCV)-infected transplant recipients in the 9-center Adult to Adult Living Donor Liver Transplantation Cohort Study, graft and patient survival and the development of advanced fibrosis were compared among 181 living donor liver transplant (LDLT) recipients and 94 deceased donor liver transplant (DDLT) recipients. Overall 3-year graft and patient survival were 68% and 74% in LDLT, and 80% and 82% in DDLT, respectively. Graft survival, but not patient survival, was significantly lower for LDLT compared to DDLT (P = 0.04 and P = 0.20, respectively). Further analyses demonstrated lower graft and patient survival among the first 20 LDLT cases at each center (LDLT ≤20) compared to later cases (LDLT > 20; P = 0.002 and P = 0.002, respectively) and DDILT recipients (P <0.001 and P = 0.008, respectively). Graft and patient survival in LDLT >20 and DDLT were not significantly different (P = 0.66 and P = 0.74, respectively). Overall, 3-year graft survival for DDLT, LDLT >20, and LDLT ≤20 were 80%, 79% and 55%, with similar results conditional on survival to 90 days (84%, 87% and 68%, respectively). Predictors of graft loss beyond 90 days included LDLT ≤20 vs. DDLT (hazard ratio [HR] = 2.1, P = 0.04), pretransplant hepatocellular carcinoma (HCC) (HR = 2.21, P = 0.03) and model for end-stage liver disease (MELD) at transplantation (HR = 1.24, P = 0.04). In conclusion, 3-year graft and patient survival in HCV-infected recipients of DDLT and LDLT >20 were not significantly different. Important predictors of graft loss in HCV-infected patients were limited LDLT experience, pretransplant HCC, and higher MELD at transplantation.

Original languageEnglish (US)
Pages (from-to)122-129
Number of pages8
JournalLiver Transplantation
Volume13
Issue number1
DOIs
StatePublished - 2007
Externally publishedYes

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Living Donors
Hepacivirus
Liver Transplantation
Tissue Donors
Transplants
Liver
Graft Survival
End Stage Liver Disease
Hepatocellular Carcinoma
Transplantation
Survival

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Terrault, N. A., Shiffman, M. L., Lok, A. S. F., Saab, S., Tong, L., Brown, R. S., ... Seeff, L. B. (2007). Outcomes in hepatitis C virus-infected recipients of living donor vs. deceased donor liver transplantation. Liver Transplantation, 13(1), 122-129. https://doi.org/10.1002/lt.20995

Outcomes in hepatitis C virus-infected recipients of living donor vs. deceased donor liver transplantation. / Terrault, Norah A.; Shiffman, Mitchell L.; Lok, Anna S F; Saab, Sammy; Tong, Lan; Brown, Robert S.; Everson, Gregory T.; Reddy, K. Rajender; Fair, Jeffrey; Kulik, Laura M.; Pruett, Timothy L.; Seeff, Leonard B.

In: Liver Transplantation, Vol. 13, No. 1, 2007, p. 122-129.

Research output: Contribution to journalArticle

Terrault, NA, Shiffman, ML, Lok, ASF, Saab, S, Tong, L, Brown, RS, Everson, GT, Reddy, KR, Fair, J, Kulik, LM, Pruett, TL & Seeff, LB 2007, 'Outcomes in hepatitis C virus-infected recipients of living donor vs. deceased donor liver transplantation', Liver Transplantation, vol. 13, no. 1, pp. 122-129. https://doi.org/10.1002/lt.20995
Terrault, Norah A. ; Shiffman, Mitchell L. ; Lok, Anna S F ; Saab, Sammy ; Tong, Lan ; Brown, Robert S. ; Everson, Gregory T. ; Reddy, K. Rajender ; Fair, Jeffrey ; Kulik, Laura M. ; Pruett, Timothy L. ; Seeff, Leonard B. / Outcomes in hepatitis C virus-infected recipients of living donor vs. deceased donor liver transplantation. In: Liver Transplantation. 2007 ; Vol. 13, No. 1. pp. 122-129.
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abstract = "In this retrospective study of hepatitis C virus (HCV)-infected transplant recipients in the 9-center Adult to Adult Living Donor Liver Transplantation Cohort Study, graft and patient survival and the development of advanced fibrosis were compared among 181 living donor liver transplant (LDLT) recipients and 94 deceased donor liver transplant (DDLT) recipients. Overall 3-year graft and patient survival were 68{\%} and 74{\%} in LDLT, and 80{\%} and 82{\%} in DDLT, respectively. Graft survival, but not patient survival, was significantly lower for LDLT compared to DDLT (P = 0.04 and P = 0.20, respectively). Further analyses demonstrated lower graft and patient survival among the first 20 LDLT cases at each center (LDLT ≤20) compared to later cases (LDLT > 20; P = 0.002 and P = 0.002, respectively) and DDILT recipients (P <0.001 and P = 0.008, respectively). Graft and patient survival in LDLT >20 and DDLT were not significantly different (P = 0.66 and P = 0.74, respectively). Overall, 3-year graft survival for DDLT, LDLT >20, and LDLT ≤20 were 80{\%}, 79{\%} and 55{\%}, with similar results conditional on survival to 90 days (84{\%}, 87{\%} and 68{\%}, respectively). Predictors of graft loss beyond 90 days included LDLT ≤20 vs. DDLT (hazard ratio [HR] = 2.1, P = 0.04), pretransplant hepatocellular carcinoma (HCC) (HR = 2.21, P = 0.03) and model for end-stage liver disease (MELD) at transplantation (HR = 1.24, P = 0.04). In conclusion, 3-year graft and patient survival in HCV-infected recipients of DDLT and LDLT >20 were not significantly different. Important predictors of graft loss in HCV-infected patients were limited LDLT experience, pretransplant HCC, and higher MELD at transplantation.",
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AU - Tong, Lan

AU - Brown, Robert S.

AU - Everson, Gregory T.

AU - Reddy, K. Rajender

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