Survival Outcome After Hepatic Retransplantation for Hepatitis C Virus–Positive and –Negative Recipients

• Published in: Transplantation proceedings 2005-09, Vol.37 (7), p.3159-3161
• Main Authors: Jain, A., Orloff, M., Abt, P., Kashyap, R., Mohanka, R., Lansing, K., Romano, J., Bozorgzadeh, A.
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft Survival; Hepatitis C - surgery; Human viral diseases; Humans; Infectious diseases; Liver Transplantation - mortality; Liver Transplantation - physiology; Male; Medical sciences; Middle Aged; Reoperation - mortality; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Survival Analysis; Time Factors; Tissue, organ and graft immunology; Viral diseases; Viral hepatitis
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2005.07.048

Hepatitis C virus (HCV)–related liver disease is the most common indication for liver transplantation in the United States. Recurrence of HCV infection in these recipients is almost uniform. The currently available antiviral treatment is known to cause significant side effects, and the rate of sustained viral response is low. There is still controversy about whether such patients should undergo subsequent transplantations for HCV disease. This study compared outcomes for hepatic retransplantation performed in HCV(+) and HCV(−) recipients at a single center. From December 1994 through November 2003, 68 patients at our institution received a second liver allograft. Nineteen of the recipients were HCV(+) (group A) and 49 were HCV(−) (group B). All patients were followed until January 2004. The mean follow-up time after initial retransplantation was 37 ± 29 months. Patient and graft survival for the two groups were compared. Seven recipients in group A (36.8%) and 22 recipients in group B (44.9%) died during follow-up. The actuarial 3-year patient survival after initial retransplantation for groups A and B were 61.7% and 51.6%, respectively. Nine patients required a second retransplantation, 3 (15.8%) in group A and 6 (12.2%) in group B. The actuarial 3-year graft survival from initial retransplantation for groups A and B were 56.3% and 45.7%, respectively. We observed slightly better patient and graft survivals at 3 years from initial retransplantation in HCV(+) recipients compared to HCV(−) recipients. This may be due to younger donor age and better selection of HCV(+) recipients in this series.