An official website of the United States government
Publication Information
Affiliation
University of California, San Francisco, San Francisco, CA.
Authors
A2ALL Study Group, Abecassis MM, Adeyi O, Akagi M, Al-Saden P, Argo CK, Armstrong DR, Ashworth A, Baker T, Berg CL, Brithinee A, Brown RS Jr, Burton JR Jr, Busuttil RW, Chawla T, Conboy B, Cotterell A, Davis J, Doo E, Emond JC, Everhart JE, Everson GT, Fenick E, Fisher RA, Freise CE, Garcia C, Gillespie BW, Golden B, Guarrera J, Hayashi PH, Heese S, Hill-Callahan M, Hofmann C, Holloway L, Hong JC, Hoofnagle JH, Howell TA, Hubbard S, James S, Kam I, Kaminski M, Krajec A, Kulik LM, Ladner DP, Lassiter A, Lok AS, Lowe M, Lukose T, MacLeod D, McCorriston D, Merion RM, Mooney J, Odeh-Ramadan R, Ojo AO, Olthoff KM, Prince MR, Pruett TL, Reddy K, Robuck PR, Rodgers C, Rodrigo del R, Rodriguez J, Rosen MA, Russell T, Saab S, Samstein B, Seeff LB, Shaked A, Shaw M, Shaw S, Shiffman ML, Smith A, Stravitz R, Stravitz RT, Terrault NA, Torrance RJ, Trotter J, Verna E, Wolfe L, Wolfe RA, Zaretsky J
Studies
Citation
Terrault NA, Stravitz RT, Lok AS, Everson GT, Brown RS Jr, Kulik LM, Olthoff KM, Saab S, Adeyi O, Argo CK, Everhart JE, Rodrigo del R, A2ALL Study Group. Hepatitis C disease severity in living versus deceased donor liver transplant recipients: an extended observation study. Hepatology 2014 Apr;59(4):1311-9. Epub 2014 Mar 1.Abstract
Donor factors influence hepatitis C virus (HCV) disease severity in liver transplant (LT) recipients. Living donors, because they are typically young and have short cold ischemic times, may be advantageous for HCV-infected patients. Among HCV-infected patients in the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL) surviving >90 days and followed for a median 4.7 years, advanced fibrosis (Ishak stage ≥3) and graft loss were determined. The 5-year cumulative risk of advanced fibrosis was 44% and 37% in living donor LT (LDLT) and deceased donor LT (DDLT) patients (P = 0.16), respectively. Aspartate aminotransferase (AST) activity at LT (hazard ratio [HR] = 1.38 for doubling of AST, P = 0.005) and biliary strictures (HR = 2.68, P = 0.0001) were associated with advanced fibrosis, but LDLT was not (HR = 1.11, 95% confidence interval [CI] 0.73-1.69, P = 0.63). The 5-year unadjusted patient and graft survival probabilities were 79% and 78% in LDLT, and 77% and 75% in DDLT (P = 0.43 and 0.32), with 27% and 20% of LDLT and DDLT graft losses due to HCV (P = 0.45). Biliary strictures (HR = 2.25, P = 0.0006), creatinine at LT (HR = 1.74 for doubling of creatinine, P = 0.0004), and AST at LT (HR = 1.36 for doubling of AST, P = 0.004) were associated with graft loss, but LDLT was not (HR = 0.76, 95% CI: 0.49-1.18, P = 0.23).