Liver transplant for hepatitis C has good outcome

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The first detailed report of outcomes after 10 years for people given a liver transplant because of hepatitis C virus (HCV) infection shows that these individuals fare just as well as those undergoing liver transplantation for other reasons.

HCV infection is “the most common indication for liver transplantation in the North America and Western Europe,” Dr. Michael Charlton from the Mayo Clinic in Rochester, Minnesota told AMN Health.

In the journal Liver Transplantation, Charlton and his colleagues report data on 165 HCV-infected liver transplant recipients who were followed for up to 12 years after transplantation.

“Long-term outcomes, specifically patient and liver graft survival, are as good for patients with hepatitis C as they are for patients with almost any other cause of liver disease,” Charlton said. “This is contrary to the findings of less complete and rigorous data sets.”

Ten-year graft survival was 64 percent for HCV-infected individuals and 51 percent for uninfected individuals.

The team also found that several factors before transplantation—such as the age of both the donor and the recipient, and the level of virus in the recipient’s blood—“were associated with a high likelihood of post-transplant death or graft failure,” Charlton said.

These variables could be used to generate a “risk score,” and a risk score above a certain level was “strongly predictive of post-transplant death or graft loss.”

Based on this score, “patients might be selected to minimize the risk,” Charlton explained. “For example, an older patient might be provided with a recipient from a younger donor,” or virus levels “might be reduced with antiviral treatment prior to transplantation when safe and practical.”

SOURCE: Liver Transplantation, September 2004.

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