Outcome of Liver Transplantation for Recipients With Hepatitis B and Hepatitis C Virus Coinfection: Analysis of the UNOS Data.

August 14, 2011

Transplantation. 2011 Aug 9. [Epub ahead of print]

Outcome of Liver Transplantation for Recipients With Hepatitis B and Hepatitis C

Virus Coinfection: Analysis of the UNOS Data.

Waki K, Sugawara Y, Tamura S, Mieno MN, Yamashiki N, Kadowaki T, Kokudo N.

Source

1 Terasaki Foundation Laboratory, Angeles, CA. 2 Department of Diabetes and

Metabolic Diseases, Graduate School of Medicine, University of Tokyo, Tokyo,

Japan. 3 Department of Ubiquitous Health Informatics, Graduate School of

Medicine, University of Tokyo, Tokyo, Japan. 4 Department of Surgery, Graduate

School of Medicine, University of Tokyo, Tokyo, Japan. 5 Department of Medical

Informatics, Center for Information, Jichi Medical University, Tochigi, Japan. 6

Department of Gastroenterology, Graduate School of Medicine, University of

Tokyo, Tokyo, Japan.

Abstract

BACKGROUND.: Coinfection by Hepatitis B virus (HBV) and hepatitis C virus (HCV)

has been reported to increase risk of graft failure for liver transplant

recipients. But other studies have controverted that finding. The aim of this

study was to determine whether-after adjustments for other important

predictors-HBV/HCV coinfection was associated with worse liver graft survival

than HBV or HCV mono-infection. METHODS.: A retrospective cohort study examined

Organ Procurement and Transplantation Network/United Network Organ Sharing data

for 48,654 deceased-donor primary liver-only transplants that were performed on

adults between January 1, 1995, and August 31, 2009, and that included recipient

and donor HBV/HCV status. Recipients were classified into four groups: the

HBV/HCV coinfected [b(+)/C(+)]; HBV mono-infected [b(+)/C(-)]; HCV mono-infected

[b(-)/C(+)]; and hepatitis uninfected [b(-)/C(-)]. Kaplan-Meier methods were

used to calculate liver graft survival rates, proportional hazard models

were used to estimate the effect of hepatitis virus infection, and adjusted for

potential confounders. RESULTS.: Graft survival rates were highest with

B(+)/C(-): 85.3% 1-year survival and 63.0% 10-year survival. Graft survival with

B(+)/C(+) was superior to survival with B(-)/C(+): 83.5% 1-year survival and

53.6% 10-year survival vs. B(-)/C(+): 82.9% 1-year survival and 46.1% 10-year

survival. Survival with B(-)/C(-): 83.6% 1-year survival and 56.6% 10-year

survival was superior to survival with B(+)/C(+) (shown above). After adjustment

for confounders, and with the coinfected as reference, B(-)/C(+) recipients had

a higher risk of graft loss (hazard ratio, 1.35; 95% CI, 1.10-1.66); the other

two groups had a lower risk. CONCLUSIONS.: Our results suggested-despite reports

to the contrary-statistically better graft outcomes with HBV/HCV coinfection

than with HCV mono-infection.

PMID: 21832961 [PubMed - as supplied by publisher]

August 14, 2011