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Excellent liver retransplantation outcomes in hepatitis C-infected recipients
A Kressel1, G Therapondos, H Bohorquez
1Multi-organ Transplant Institute, Ochsner Medical Center, New Orleans, LA 70121, USA.
Insights
Liver retransplantation in Hepatitis C Virus (HCV) patients shows improved survival rates in our center compared to national data. Our outcomes demonstrate that HCV-LRTx can achieve results comparable to standard liver transplantation.
Area of Science:
- Hepatology
- Transplantation Surgery
- Virology
Background:
- Liver retransplantation (LRTx) outcomes for Hepatitis C Virus (HCV) patients are often considered inferior.
- This study addresses the survival rates of HCV-LRTx at a single center versus national data.
Purpose of the Study:
- To compare the outcomes of LRTx in HCV antibody-positive patients at our center with those in the national OPTN database.
- To evaluate patient and graft survival rates for HCV-LRTx.
Main Methods:
- Retrospective analysis of 116 LRTx cases (2005-2011), with a focus on 29 HCV antibody-positive patients.
- Comparison of our center's HCV-LRTx outcomes with data from the OPTN database for the same period.
- Analysis included patient demographics, baseline characteristics, survival rates, and transplant specifics like ischemic times.
Main Results:
- Our center's HCV-LRTx one-, three-, and five-year patient survival rates were 86.2%, 79.0%, and 72.4%, significantly higher than OPTN rates (73.3%, 59.0%, 51.3%).
- Graft survival rates at our center also surpassed OPTN rates across all time points.
- A higher percentage of simultaneous liver/kidney transplants (SLK) and shorter warm and cold ischemic times were observed in our HCV-LRTx cohort.
Conclusions:
- HCV-LRTx patient and graft survival rates at our center are comparable to overall LTx survival rates.
- Our findings suggest that HCV-LRTx outcomes at experienced centers can exceed those reported in national databases like OPTN.
Unlabelled:
Survival outcomes for liver retransplantation (LRTx) after graft loss in HCV patients (HCV-LRTx) are generally considered inferior to those after non-HCV-LRTx. Between January 1, 2005 and June 30, 2011, our center performed 663 LTx, including 116 (17.5%) LRTx, 41 (35.3%) of which were more than 90 d after the LTx. Twenty-nine (70.7%) LRTx were performed in HCV antibody-positive individuals. We compared patient demographics, baseline characteristics and outcomes of our HCV-LRTx group with the HCV-LRTx patients from the most recent OPTN database covering the same time period. Our Kaplan-Meier HCV-LRTx one-, three-, and five-yr HCV-LRTx patient survival rates were 86.2%, 79.0%, and 72.4%, respectively compared with the OPTN one-, three-, and five-yr HCV-LRTx survival rates of 73.3%, 59.0%, and 51.3% respectively. Likewise, our graft survival rates were higher than OPTN rates at all time points studied. We performed a higher percentage of HCV-LRTx as simultaneous liver/kidney transplants (SLK) (37.9% vs. 21.8%) and recorded shorter warm (30 ± 4 vs. 45 ± 23 min) and cold ischemic times (5:44 ± 1:53 vs. 7:36 ± 3:12 h:min).
Conclusion:
In our experience, HCV-LRTx patient and graft survival rates are comparable to LTx survival rates and are higher than the rates described by OPTN.
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