Abstract
In HCV cirrhotic patients after liver transplantation, survival and recurrence of HCV appears to be worsening in recent years. Donor age has been suggested as a cause. However, it is not clear if early and/or late mortality is affected and whether donor age is a key factor, as opposed to changes in immunosuppression. The aim of this study was to assess impact of donor age and other factors with respect to the severity of HCV recurrence posttransplant. A consecutive series of 193 HCV cirrhotic patients were transplanted with cadaveric donors, median age 41.5 years (13-73) and median follow-up of 38 months (1-155). Donor age and other factors were examined in a univariate/multivariate model for early/late survival, as well as fibrosis (grade 4 or more, Ishak score) with regular biopsies, 370 in total, from 1 year onwards. Results of the study indicated that donor age influenced only short-term (3 months) survival, with no significant effect on survival after 3 months. Known HCC independently adversely affected survival, as did the absence of maintenance azathioprine. Severe fibrosis (stage ≥ 4) in 51 patients was related to neither donor age nor year of transplantation, but it was independently associated with combined biochemical/histological hepatitis flare (OR 2.9, 95% CI 1.76-4.9) whereas maintenance steroids were protective (OR 0.4, 95% CI 0.23-0.83). In conclusion, in this cohort donor age did not influence late mortality in HCV transplanted cirrhotic patients or development of severe fibrosis, which was related to absence of maintenance steroids and a hepatitis flare. Maintenance azathioprine gave survival advantage.
| Original language | English |
|---|---|
| Pages (from-to) | 386-395 |
| Number of pages | 10 |
| Journal | Liver Transplantation |
| Volume | 11 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Apr 2005 |
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ASJC Scopus subject areas
- Surgery
- Transplantation
Cite this
Immunosuppresion and donor age with respect to severity of HCV recurrence after liver transplantation. / Samonakis, Dimitrios N.; Triantos, Christos K.; Thalheimer, Ulrich; Quaglia, Alberto; Leandro, Gioacchino; Teixeira, Rosângela; Papatheodoridis, George V.; Sabin, Caroline A.; Rolando, Nancy; Davies, Susan; Dhillon, Amar P.; Griffiths, Paul; Emery, Vincent; Patch, Daivd W.; Davidson, B. R.; Rolles, Keith; Burroughs, Andrew K.
In: Liver Transplantation, Vol. 11, No. 4, 04.2005, p. 386-395.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Immunosuppresion and donor age with respect to severity of HCV recurrence after liver transplantation
AU - Samonakis, Dimitrios N.
AU - Triantos, Christos K.
AU - Thalheimer, Ulrich
AU - Quaglia, Alberto
AU - Leandro, Gioacchino
AU - Teixeira, Rosângela
AU - Papatheodoridis, George V.
AU - Sabin, Caroline A.
AU - Rolando, Nancy
AU - Davies, Susan
AU - Dhillon, Amar P.
AU - Griffiths, Paul
AU - Emery, Vincent
AU - Patch, Daivd W.
AU - Davidson, B. R.
AU - Rolles, Keith
AU - Burroughs, Andrew K.
PY - 2005/4
Y1 - 2005/4
N2 - In HCV cirrhotic patients after liver transplantation, survival and recurrence of HCV appears to be worsening in recent years. Donor age has been suggested as a cause. However, it is not clear if early and/or late mortality is affected and whether donor age is a key factor, as opposed to changes in immunosuppression. The aim of this study was to assess impact of donor age and other factors with respect to the severity of HCV recurrence posttransplant. A consecutive series of 193 HCV cirrhotic patients were transplanted with cadaveric donors, median age 41.5 years (13-73) and median follow-up of 38 months (1-155). Donor age and other factors were examined in a univariate/multivariate model for early/late survival, as well as fibrosis (grade 4 or more, Ishak score) with regular biopsies, 370 in total, from 1 year onwards. Results of the study indicated that donor age influenced only short-term (3 months) survival, with no significant effect on survival after 3 months. Known HCC independently adversely affected survival, as did the absence of maintenance azathioprine. Severe fibrosis (stage ≥ 4) in 51 patients was related to neither donor age nor year of transplantation, but it was independently associated with combined biochemical/histological hepatitis flare (OR 2.9, 95% CI 1.76-4.9) whereas maintenance steroids were protective (OR 0.4, 95% CI 0.23-0.83). In conclusion, in this cohort donor age did not influence late mortality in HCV transplanted cirrhotic patients or development of severe fibrosis, which was related to absence of maintenance steroids and a hepatitis flare. Maintenance azathioprine gave survival advantage.
AB - In HCV cirrhotic patients after liver transplantation, survival and recurrence of HCV appears to be worsening in recent years. Donor age has been suggested as a cause. However, it is not clear if early and/or late mortality is affected and whether donor age is a key factor, as opposed to changes in immunosuppression. The aim of this study was to assess impact of donor age and other factors with respect to the severity of HCV recurrence posttransplant. A consecutive series of 193 HCV cirrhotic patients were transplanted with cadaveric donors, median age 41.5 years (13-73) and median follow-up of 38 months (1-155). Donor age and other factors were examined in a univariate/multivariate model for early/late survival, as well as fibrosis (grade 4 or more, Ishak score) with regular biopsies, 370 in total, from 1 year onwards. Results of the study indicated that donor age influenced only short-term (3 months) survival, with no significant effect on survival after 3 months. Known HCC independently adversely affected survival, as did the absence of maintenance azathioprine. Severe fibrosis (stage ≥ 4) in 51 patients was related to neither donor age nor year of transplantation, but it was independently associated with combined biochemical/histological hepatitis flare (OR 2.9, 95% CI 1.76-4.9) whereas maintenance steroids were protective (OR 0.4, 95% CI 0.23-0.83). In conclusion, in this cohort donor age did not influence late mortality in HCV transplanted cirrhotic patients or development of severe fibrosis, which was related to absence of maintenance steroids and a hepatitis flare. Maintenance azathioprine gave survival advantage.
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U2 - 10.1002/lt.20344
DO - 10.1002/lt.20344
M3 - Article
VL - 11
SP - 386
EP - 395
JO - Liver Transplantation
JF - Liver Transplantation
SN - 1527-6465
IS - 4
ER -