AASLD: Mortality Risk in HCV-Positive Transplant Patients Similar Regardless of Donor Status

[Guest guest]

http://www.medpagetoday.com/MeetingCoverage/AASLD/11601

Medical News from

AASLD: American Association for the Study of Liver Diseases Meeting

AASLD: Mortality Risk in HCV-Positive Transplant Patients Similar Regardless of

Donor Status

By Bankhead, Staff Writer, MedPage Today

Published: November 04, 2008

Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine,

Harvard Medical School, Boston.

SAN FRANCISCO, Nov. 4 -- Hepatitis C-positive liver transplant recipients live

just as long whether the donor is HCV-positive or -negative, data from the

national transplant network suggest.

HCV-positive organ recipients lived an average of 8.28 years after receiving a

liver from an HCV-positive donor, G. Northrup, M.D., of the University

of Virginia in Charlottesville, reported here at the annual meeting of the

American Association for the Study of Liver Diseases.

After adjustment for known mortality risks associated with HCV, the survival did

not differ from the 10-year mean among HCV-positive patients who received livers

from HCV-negative donors. Action Points

--------------------------------------------------------------------------------

Explain to interested patients that liver transplant patients infected with HCV

do equally well with organs from HCV-positive or -negative donors, although not

as well as HCV-negative transplant recipients.

Note that this study was published as an abstract and presented orally at a

conference. These data and conclusions should be considered to be preliminary

until published in a peer-reviewed journal.

" It looks like recipients with hepatitis C can receive an organ from someone

with the hepatitis C antibodies and do as well as they would with a

non-hepatitis C donor, " said Dr. Northrup. " That's with careful patient

selection. "

The need for donor livers far exceeds the supply, and extended-criteria donor

selection has offered a partial solution to the organ shortage, Dr. Northrup

noted. Use of HCV-positive grafts for HCV-positive patients offers an example of

marginal-donor expansion.

Cirrhosis secondary to HCV infection has accounted for as many as half of all

liver transplants performed in the U.S., and more than four million people are

currently infected, Dr. Northrup continued.

The issue of transplanting organs from HCV-positive donors has particular

relevance in that population of liver transplant patients, he said, but the

long-term consequences and outcomes had not been carefully studied.

So Dr. Northrup and colleagues analyzed the United Network for Organ

Sharing/Organ Procurement and Transplantation Network dataset to identify all

adult liver transplantations from January 1994 to February 2008 involving

HCV-positive donors.

Patient and graft survival were assessed separately, accounting for donor and

recipient HCV status.

Of 70,071 liver transplantations evaluated, 23,972 involved HCV-positive

recipients, and 1,313 transplant procedures involved HCV-positive donors.

Three-fourths of HCV-positive donor organs went to HCV-positive recipients, and

the remaining organs were given to HCV-negative patients in rare and extreme

circumstances, said Dr. Northrup.

Transplants involving HCV-negative donors and recipients were associated with

the best survival, an average of 11.7 years.

From that subgroup, mean survival decreased to 10.0 years for HCV-positive

patients and HCV-negative donors; 8.28 years for HCV-positive donors and

HCV-positive recipients; and 6.33 years for HCV-negative patients who received

organs from HCV-positive donors.

HCV-negative patients who received livers from HCV-positive donors had the worst

Model for End-Stage Liver Disease (MELD) score and more severe illness.

The researchers developed a survival model that adjusted for multiple variables

known to affect survival after transplantation.

Using survival associated with transplants involving HCV-negative patients and

donors as the reference, the investigators found that all other combinations

increased the mortality hazard ratio by about 20%.

The mortality difference achieved statistical significance for the combination

of HCV-positive recipients and HCV-negative donors (HR 1.21, 95% CI 1.17 to

1.25, P

[Guest guest]

http://www.medpagetoday.com/MeetingCoverage/AASLD/11601

Medical News from

AASLD: American Association for the Study of Liver Diseases Meeting

AASLD: Mortality Risk in HCV-Positive Transplant Patients Similar Regardless of

Donor Status

By Bankhead, Staff Writer, MedPage Today

Published: November 04, 2008

Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine,

Harvard Medical School, Boston.

SAN FRANCISCO, Nov. 4 -- Hepatitis C-positive liver transplant recipients live

just as long whether the donor is HCV-positive or -negative, data from the

national transplant network suggest.

HCV-positive organ recipients lived an average of 8.28 years after receiving a

liver from an HCV-positive donor, G. Northrup, M.D., of the University

of Virginia in Charlottesville, reported here at the annual meeting of the

American Association for the Study of Liver Diseases.

After adjustment for known mortality risks associated with HCV, the survival did

not differ from the 10-year mean among HCV-positive patients who received livers

from HCV-negative donors. Action Points

--------------------------------------------------------------------------------

Explain to interested patients that liver transplant patients infected with HCV

do equally well with organs from HCV-positive or -negative donors, although not

as well as HCV-negative transplant recipients.

Note that this study was published as an abstract and presented orally at a

conference. These data and conclusions should be considered to be preliminary

until published in a peer-reviewed journal.

" It looks like recipients with hepatitis C can receive an organ from someone

with the hepatitis C antibodies and do as well as they would with a

non-hepatitis C donor, " said Dr. Northrup. " That's with careful patient

selection. "

The need for donor livers far exceeds the supply, and extended-criteria donor

selection has offered a partial solution to the organ shortage, Dr. Northrup

noted. Use of HCV-positive grafts for HCV-positive patients offers an example of

marginal-donor expansion.

Cirrhosis secondary to HCV infection has accounted for as many as half of all

liver transplants performed in the U.S., and more than four million people are

currently infected, Dr. Northrup continued.

The issue of transplanting organs from HCV-positive donors has particular

relevance in that population of liver transplant patients, he said, but the

long-term consequences and outcomes had not been carefully studied.

So Dr. Northrup and colleagues analyzed the United Network for Organ

Sharing/Organ Procurement and Transplantation Network dataset to identify all

adult liver transplantations from January 1994 to February 2008 involving

HCV-positive donors.

Patient and graft survival were assessed separately, accounting for donor and

recipient HCV status.

Of 70,071 liver transplantations evaluated, 23,972 involved HCV-positive

recipients, and 1,313 transplant procedures involved HCV-positive donors.

Three-fourths of HCV-positive donor organs went to HCV-positive recipients, and

the remaining organs were given to HCV-negative patients in rare and extreme

circumstances, said Dr. Northrup.

Transplants involving HCV-negative donors and recipients were associated with

the best survival, an average of 11.7 years.

From that subgroup, mean survival decreased to 10.0 years for HCV-positive

patients and HCV-negative donors; 8.28 years for HCV-positive donors and

HCV-positive recipients; and 6.33 years for HCV-negative patients who received

organs from HCV-positive donors.

HCV-negative patients who received livers from HCV-positive donors had the worst

Model for End-Stage Liver Disease (MELD) score and more severe illness.

The researchers developed a survival model that adjusted for multiple variables

known to affect survival after transplantation.

Using survival associated with transplants involving HCV-negative patients and

donors as the reference, the investigators found that all other combinations

increased the mortality hazard ratio by about 20%.

The mortality difference achieved statistical significance for the combination

of HCV-positive recipients and HCV-negative donors (HR 1.21, 95% CI 1.17 to

1.25, P

[Guest guest]

http://www.medpagetoday.com/MeetingCoverage/AASLD/11601

Medical News from

AASLD: American Association for the Study of Liver Diseases Meeting

AASLD: Mortality Risk in HCV-Positive Transplant Patients Similar Regardless of

Donor Status

By Bankhead, Staff Writer, MedPage Today

Published: November 04, 2008

Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine,

Harvard Medical School, Boston.

SAN FRANCISCO, Nov. 4 -- Hepatitis C-positive liver transplant recipients live

just as long whether the donor is HCV-positive or -negative, data from the

national transplant network suggest.

HCV-positive organ recipients lived an average of 8.28 years after receiving a

liver from an HCV-positive donor, G. Northrup, M.D., of the University

of Virginia in Charlottesville, reported here at the annual meeting of the

American Association for the Study of Liver Diseases.

After adjustment for known mortality risks associated with HCV, the survival did

not differ from the 10-year mean among HCV-positive patients who received livers

from HCV-negative donors. Action Points

--------------------------------------------------------------------------------

Explain to interested patients that liver transplant patients infected with HCV

do equally well with organs from HCV-positive or -negative donors, although not

as well as HCV-negative transplant recipients.

Note that this study was published as an abstract and presented orally at a

conference. These data and conclusions should be considered to be preliminary

until published in a peer-reviewed journal.

" It looks like recipients with hepatitis C can receive an organ from someone

with the hepatitis C antibodies and do as well as they would with a

non-hepatitis C donor, " said Dr. Northrup. " That's with careful patient

selection. "

The need for donor livers far exceeds the supply, and extended-criteria donor

selection has offered a partial solution to the organ shortage, Dr. Northrup

noted. Use of HCV-positive grafts for HCV-positive patients offers an example of

marginal-donor expansion.

Cirrhosis secondary to HCV infection has accounted for as many as half of all

liver transplants performed in the U.S., and more than four million people are

currently infected, Dr. Northrup continued.

The issue of transplanting organs from HCV-positive donors has particular

relevance in that population of liver transplant patients, he said, but the

long-term consequences and outcomes had not been carefully studied.

So Dr. Northrup and colleagues analyzed the United Network for Organ

Sharing/Organ Procurement and Transplantation Network dataset to identify all

adult liver transplantations from January 1994 to February 2008 involving

HCV-positive donors.

Patient and graft survival were assessed separately, accounting for donor and

recipient HCV status.

Of 70,071 liver transplantations evaluated, 23,972 involved HCV-positive

recipients, and 1,313 transplant procedures involved HCV-positive donors.

Three-fourths of HCV-positive donor organs went to HCV-positive recipients, and

the remaining organs were given to HCV-negative patients in rare and extreme

circumstances, said Dr. Northrup.

Transplants involving HCV-negative donors and recipients were associated with

the best survival, an average of 11.7 years.

From that subgroup, mean survival decreased to 10.0 years for HCV-positive

patients and HCV-negative donors; 8.28 years for HCV-positive donors and

HCV-positive recipients; and 6.33 years for HCV-negative patients who received

organs from HCV-positive donors.

HCV-negative patients who received livers from HCV-positive donors had the worst

Model for End-Stage Liver Disease (MELD) score and more severe illness.

The researchers developed a survival model that adjusted for multiple variables

known to affect survival after transplantation.

Using survival associated with transplants involving HCV-negative patients and

donors as the reference, the investigators found that all other combinations

increased the mortality hazard ratio by about 20%.

The mortality difference achieved statistical significance for the combination

of HCV-positive recipients and HCV-negative donors (HR 1.21, 95% CI 1.17 to

1.25, P

[Guest guest]

http://www.medpagetoday.com/MeetingCoverage/AASLD/11601

Medical News from

AASLD: American Association for the Study of Liver Diseases Meeting

AASLD: Mortality Risk in HCV-Positive Transplant Patients Similar Regardless of

Donor Status

By Bankhead, Staff Writer, MedPage Today

Published: November 04, 2008

Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine,

Harvard Medical School, Boston.

SAN FRANCISCO, Nov. 4 -- Hepatitis C-positive liver transplant recipients live

just as long whether the donor is HCV-positive or -negative, data from the

national transplant network suggest.

HCV-positive organ recipients lived an average of 8.28 years after receiving a

liver from an HCV-positive donor, G. Northrup, M.D., of the University

of Virginia in Charlottesville, reported here at the annual meeting of the

American Association for the Study of Liver Diseases.

After adjustment for known mortality risks associated with HCV, the survival did

not differ from the 10-year mean among HCV-positive patients who received livers

from HCV-negative donors. Action Points

--------------------------------------------------------------------------------

Explain to interested patients that liver transplant patients infected with HCV

do equally well with organs from HCV-positive or -negative donors, although not

as well as HCV-negative transplant recipients.

Note that this study was published as an abstract and presented orally at a

conference. These data and conclusions should be considered to be preliminary

until published in a peer-reviewed journal.

" It looks like recipients with hepatitis C can receive an organ from someone

with the hepatitis C antibodies and do as well as they would with a

non-hepatitis C donor, " said Dr. Northrup. " That's with careful patient

selection. "

The need for donor livers far exceeds the supply, and extended-criteria donor

selection has offered a partial solution to the organ shortage, Dr. Northrup

noted. Use of HCV-positive grafts for HCV-positive patients offers an example of

marginal-donor expansion.

Cirrhosis secondary to HCV infection has accounted for as many as half of all

liver transplants performed in the U.S., and more than four million people are

currently infected, Dr. Northrup continued.

The issue of transplanting organs from HCV-positive donors has particular

relevance in that population of liver transplant patients, he said, but the

long-term consequences and outcomes had not been carefully studied.

So Dr. Northrup and colleagues analyzed the United Network for Organ

Sharing/Organ Procurement and Transplantation Network dataset to identify all

adult liver transplantations from January 1994 to February 2008 involving

HCV-positive donors.

Patient and graft survival were assessed separately, accounting for donor and

recipient HCV status.

Of 70,071 liver transplantations evaluated, 23,972 involved HCV-positive

recipients, and 1,313 transplant procedures involved HCV-positive donors.

Three-fourths of HCV-positive donor organs went to HCV-positive recipients, and

the remaining organs were given to HCV-negative patients in rare and extreme

circumstances, said Dr. Northrup.

Transplants involving HCV-negative donors and recipients were associated with

the best survival, an average of 11.7 years.

From that subgroup, mean survival decreased to 10.0 years for HCV-positive

patients and HCV-negative donors; 8.28 years for HCV-positive donors and

HCV-positive recipients; and 6.33 years for HCV-negative patients who received

organs from HCV-positive donors.

HCV-negative patients who received livers from HCV-positive donors had the worst

Model for End-Stage Liver Disease (MELD) score and more severe illness.

The researchers developed a survival model that adjusted for multiple variables

known to affect survival after transplantation.

Using survival associated with transplants involving HCV-negative patients and

donors as the reference, the investigators found that all other combinations

increased the mortality hazard ratio by about 20%.

The mortality difference achieved statistical significance for the combination

of HCV-positive recipients and HCV-negative donors (HR 1.21, 95% CI 1.17 to

1.25, P