Improving graft survival for patients undergoing liver transplantation

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Improving graft survival for patients undergoing liver transplantation

Rolland C. Dickson1, Surakit Pungpapong2, P. Keaveny2, C. Burcin Taner2,

Marwan Ghabril3, Aranda-Michel2, Raj Satyanarayana2, Hugo Bonatti4,

J. Kramer2, H. Nguyen2Article first published online: 23 MAR 2011

DOI: 10.1111/j.1399-0012.2011.01428.x

© 2011 Wiley & Sons A/S.

Issue

Clinical Transplantation

Early View (Articles online in advance of print)

Author Information

1Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH

2Department of Transplantation, Mayo Clinic, ville, FL

3Department of Medicine, Clarian/Indiana University, Indianapolis, IN

4Department of Surgery, University of Virginia, Charlottesville, VA, USA

*Correspondence: Corresponding author: Rolland C. Dickson, MD, Director

Hepatology Section of Gastroenterology & Hepatology, Dartmouth Hitchcock Medical

Center, One Medical Center Drive, Lebanon, NH 03756-0001, USA. Tel.: 603 650

6734; fax: 603 650 5225; e-mail: Rolland.C.Dickson@...

Conflict of interest: None.

Conflict of interest: None.

Publication History

Article first published online: 23 MAR 2011

Accepted for publication 03 February 2011

Abstract:  Liver transplant (LT) outcomes are reported to be improving in

non-HCV recipients but not for those infected with HCV. Our aim was to evaluate

graft survival and predictors of outcome in HCV and non-HCV patients before and

after 2003. Patients with primary LT between February 1, 1998, and December 31,

2005, were included. Patients were divided into Era 1 (1998–2002) and Era 2

(2003–2005) with follow-up through May 31, 2009. Graft survival was compared

for HCV, non-HCV, and all patients. There was significant improvement in graft

survival in Era 2 for HCV patients. Graft survival in Era 2 of HCV patients was

equivalent to non-HCV patients. The most significant improvement between eras

was in outcomes of grafts from donors ≥60 yr with three-yr graft survival 58.6

(51.3–65.9) vs. 75.4 (68.9–81.9), p = 0.002. The use of donors ≥60 did not

change between eras: 31% vs. 34%; however, utilization in HCV recipients

decreased from 36% to 3% (p < 0.001). In conclusion, graft survival of HCV

patients has improved significantly since 2003 and was comparable to non-HCV

patients up to three yr. The change in management of donor organs into HCV and

non-HCV patients likely contributed to this outcome.