Retransplantation for Hepatitis C: Results of a U.S. Multicenter Retransplant Study

T. Mccashland, K. Watt, E. Lyden, Leon Adams, M. Charlton, A.D. Smith, B.M. Mcguire, S.W. Biggins, G. Neff, J.R. Burton Jr., H. Vargas, J. Donovan, J. Trotter, T. Faust

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    Abstract

    It is widely perceived that outcomes are relatively poor following retransplantation (reTX) for recurrent of hepatitis C virus (HCV) infection. Transplant centers debate the utility of offering another liver to these patients. A U.S. study group was formed to retrospectively compare survival after reTX in patients with recurrent HCV (histologically proven) and those transplanted for other indications greater than 90 days after first transplantation, from 1996 to 2004. Patients were divided into 3 groups; group 1: HCV reTX (n = 43), group 2: non-HCV reTX (n = 73), and group 3: recurrent HCV but no reTX (n = 156). They were predominantly male, Caucasian, with mean age of 47.2 yr. The commonest indications for non-HCV reTX were chronic rejection (36%), hepatic artery thrombosis (31%) and recurrent primary sclerosing cholangitis (17%). Duration of hospitalization, number of intensive care unit (ICU) days, and time interval from listing to transplantation or reTX were similar between reTX groups. The 1-yr and 3-yr survival rates after reTX were also similar for HCV reTX and non-HCV reTX groups (1 yr, 69% vs. 73%; 3 yr, 49% vs. 55%). Model for End-Stage Liver Disease (MELD) scores were not predictive of survival from reTX. However, with a MELD score of >30 in the non HCV group, survival was 30. Many patients with recurrent HCV are not considered for reTX and die from recurrent disease. Liver Transpl 13:1246–1253, 2007. © 2007 AASLD.
    Original languageEnglish
    Pages (from-to)1246-1253
    JournalLiver Transplantation
    Volume13
    Issue number9
    DOIs
    Publication statusPublished - 2007

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