Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
2006-1-4
pubmed:abstractText
Organ cold/warm ischemia is thought to be a risk factor for increased severity of recurrence of hepatitis C (HCV) post liver transplantation. We had noted some HCV patients with preservation injury (PI) to have particularly poor outcomes. Our goal was to determine if PI on biopsy in HCV patients is associated with earlier, more rapidly progressive recurrence or graft and patient survival. Sixty-nine patients from the University of Nebraska transplant database were included: 23 HCV patients with PI (group = 1), 23 non-HCV patients with PI (group = 2), and 23 HCV patients without PI (group = 3). Patient groups were matched for gender, age, immunosuppression, and time of transplantation for analysis. No difference in time to recurrence was noted between HCV groups (256 vs. 316 days posttransplant). More patients in group 1 had progression to stage 3 or 4 fibrosis, compared to group 3 (43 vs. 9%, P = 0.02). One-year survival for groups 1, 2, and 3 was 78, 82, and 100% respectively, whereas 3-yr survival was 59, 82, and 88% (group 1 vs. group 2 or 3 respectively, P = 0.0055). There was no difference in survival between groups 2 and 3. Patients in group 1 that received antiviral treatment had improved survival, compared to those who did not (P = 0.012). Risk factors for poor survival on univariate analysis included severity of PI (Relative Risk = 2.78, P < 0.001) and donor age of >55 (P = 0.014). Multivariate analysis shows HCV is the most important factor. In conclusion, HCV transplant patients with evidence of early PI on biopsy have poorer survival outcomes than non-HCV transplant patients with PI or HCV transplant patients without PI. Consideration for antiviral therapy early in the posttransplant course may be warranted in this subset of patients.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jan
pubmed:issn
1527-6465
pubmed:author
pubmed:copyrightInfo
Copyright 2005 AASLD
pubmed:issnType
Print
pubmed:volume
12
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
134-9
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:16382465-Biopsy, Needle, pubmed-meshheading:16382465-Case-Control Studies, pubmed-meshheading:16382465-Disease Progression, pubmed-meshheading:16382465-Female, pubmed-meshheading:16382465-Graft Rejection, pubmed-meshheading:16382465-Hepatitis C, Chronic, pubmed-meshheading:16382465-Humans, pubmed-meshheading:16382465-Immunohistochemistry, pubmed-meshheading:16382465-Immunosuppressive Agents, pubmed-meshheading:16382465-Incidence, pubmed-meshheading:16382465-Liver Failure, pubmed-meshheading:16382465-Liver Function Tests, pubmed-meshheading:16382465-Liver Transplantation, pubmed-meshheading:16382465-Male, pubmed-meshheading:16382465-Middle Aged, pubmed-meshheading:16382465-Multivariate Analysis, pubmed-meshheading:16382465-Postoperative Complications, pubmed-meshheading:16382465-Probability, pubmed-meshheading:16382465-Prognosis, pubmed-meshheading:16382465-Proportional Hazards Models, pubmed-meshheading:16382465-Recurrence, pubmed-meshheading:16382465-Reference Values, pubmed-meshheading:16382465-Reperfusion Injury, pubmed-meshheading:16382465-Retrospective Studies, pubmed-meshheading:16382465-Risk Assessment, pubmed-meshheading:16382465-Severity of Illness Index, pubmed-meshheading:16382465-Survival Analysis, pubmed-meshheading:16382465-Transplantation Immunology
pubmed:year
2006
pubmed:articleTitle
Recurrent hepatitis C posttransplant: early preservation injury may predict poor outcome.
pubmed:affiliation
Internal Medicine/GI/Hepatology, Dalhousie University, Halifax, Nova Scotia, Canada. wattk@cdha.nshealth.ca
pubmed:publicationType
Journal Article, Comparative Study