Linked Life Data

17370330

Source:http://linkedlifedata.com/resource/pubmed/id/17370330

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
5
pubmed:dateCreated
2007-5-24
pubmed:abstractText
In recent years, a worsening outcome of hepatitis C virus (HCV)-positive recipients and a faster progression of recurrent disease to overt cirrhosis has been reported. Our aims were to 1) assess patient survival and development of severe recurrent disease (Ishak fibrosis score > 3) in different transplant years; and 2) model the effects of pre- and post-liver transplantation (LT) variables on the severity of recurrent disease. A multicenter retrospective analysis was conducted on 502 consecutive HCV-positive transplant recipients between January 1990 and December 2002. Protocol liver biopsies were obtained at 1, 3, 5, 7, and 10 yr post-LT in almost 90% of the patients. All 502 patients were included in the overall survival analysis, while only the 354 patients with a follow-up longer than 1 yr were considered for the analysis of predictors of disease progression. The overall Kaplan-Meier survival rates were 78.7%, 66.3%, and 58.6%, at 12, 60, and 120 months, respectively, and a trend for a better patient survival over the years emerged from all 3 centers. The cumulative probability of developing HCV-related recurrent severe fibrosis (Ishak score 4-6) in the cohort of 354 patients who survived at least 1 yr remained unchanged over the years. Multivariate analysis indicated that older donors (P = 0.0001) and female gender of recipient (P = 0.02) were the 2 major risk factors for the development of severe recurrent disease, while the adoption of antilymphocytic preparations was associated with a less aggressive course (P = 0.03). Two of these prognostic factors, donor age and recipient gender, are easily available before LT and their combination showed an important synergy, such that a female recipient not only had a much higher probability of severe recurrent disease than a male recipient but her risk increased with the increasing age of the donor, reaching almost 100% when the age of the donor was 60 or older. In conclusion, a trend for a better patient survival was observed in more recent years but the cumulative probability of developing severe recurrent disease remained unchanged. The combination of a female recipient receiving an older graft emerged as a strong risk factor for a severe recurrence.
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
May
pubmed:issn
1527-6465
pubmed:author
pubmed:issnType
Print
pubmed:volume
13
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
733-40
pubmed:dateRevised
2010-11-18
pubmed:meshHeading
pubmed-meshheading:17370330-Adult, pubmed-meshheading:17370330-Age Factors, pubmed-meshheading:17370330-Cohort Studies, pubmed-meshheading:17370330-Disease Progression, pubmed-meshheading:17370330-Female, pubmed-meshheading:17370330-Hepatitis C, pubmed-meshheading:17370330-Humans, pubmed-meshheading:17370330-Kaplan-Meier Estimate, pubmed-meshheading:17370330-Liver Cirrhosis, pubmed-meshheading:17370330-Liver Transplantation, pubmed-meshheading:17370330-Longitudinal Studies, pubmed-meshheading:17370330-Male, pubmed-meshheading:17370330-Middle Aged, pubmed-meshheading:17370330-Recurrence, pubmed-meshheading:17370330-Retrospective Studies, pubmed-meshheading:17370330-Risk Factors, pubmed-meshheading:17370330-Severity of Illness Index, pubmed-meshheading:17370330-Sex Factors, pubmed-meshheading:17370330-Time Factors, pubmed-meshheading:17370330-Tissue Donors
pubmed:year
2007
pubmed:articleTitle
Liver transplantation for HCV cirrhosis: improved survival in recent years and increased severity of recurrent disease in female recipients: results of a long term retrospective study.
pubmed:affiliation
Hepatology and Abdominal Organ Transplantation Unit, Niguarda Hospital, Milan, Italy. luca.belli@ospedaleniguarda.it
pubmed:publicationType
Journal Article, Multicenter Study