Improving Outcomes of Liver Retransplantation: An Analysis of Trends and the Impact of Hepatitis C I

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American Journal of Transplantation 8 (2), 404–411.

doi:10.1111/j.1600-6143.2007.02082.x

Abstract

Improving Outcomes of Liver Retransplantation: An Analysis of Trends and the

Impact of Hepatitis C Infection

M. GhabrilaaDepartment of Gastroenterology and Hepatology, Mayo Clinic,

ville, FL, R. Dicksona,*aDepartment of Gastroenterology and Hepatology,

Mayo Clinic, ville, FL*Corresponding author: Rolland Dickson,

dickson.rolland1@... and R. WiesnerbbDepartment of Gastroenterology and

Hepatology, Mayo Clinic, Rochester, MNaDepartment of Gastroenterology and

Hepatology, Mayo Clinic, ville, FL bDepartment of Gastroenterology and

Hepatology, Mayo Clinic, Rochester, MN

*Corresponding author: Rolland Dickson, dickson.rolland1@...

Abstract

Retransplantation (RT) in Hepatitis C (HCV) patients remains controversial.

Aims: To study trends in RT and evaluate the impact of HCV status in the context

of a comprehensive recipient and donor risk assessment. The UNOS database

between 1994 and October 2005 was utilized to analyze 46 982 LT and RT. Graft

and patient survival along with patient and donor characteristics were compared

for 2283 RT performed in HCV and non-HCV patients during 1994–1997, 1998–2001

and 2002–October 2005. Overall HCV prevalence at RT increased from 36% in the

initial period to 40.6% after 2002. In our study group, 1-year patient and graft

survival post-RT improved over the same time intervals from 65.0% to 70.7% and

54.87% to 65.8%, respectively. HCV was only associated with decreased patient

and graft survival with a retransplant (LT-RT) interval (RI)>90 days.

Independent predictors of mortality for RT with RI>90 days were patient age,

MELD score>25, RI

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