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©The Author(s) 2016.
World J Gastroenterol. May 14, 2016; 22(18): 4547-4558
Published online May 14, 2016. doi: 10.3748/wjg.v22.i18.4547
Published online May 14, 2016. doi: 10.3748/wjg.v22.i18.4547
Table 1 Distribution of hepatitis C virus-related cases of advanced fibrosis/fibrosing cholestatic hepatitis cases after liver transplantation with and without liver retransplantation according to center n (%)
Center | n (LT) | LT related to HCV (percent of total LT) | F3/F4/FCH after LT (percent of LT for HCV) | F3/F4/FCH reLT (percent of LT for HCV) | F3/F4/FCH without ReLT (percent of LT for HCV) |
1 | 1933 | 770 (40) | 174 (23) | 31 (4) | 143 (19) |
2 | 2001 | 420 (21) | 108 (26) | 26 (6) | 82 (20) |
3 | 2124 | 412 (19) | 20 (5) | 12 (3) | 8 (2) |
4 | 1477 | 321 (22) | 40 (12) | 11 (3) | 29 (9) |
5 | 920 | 247 (27) | 33 (13) | 10 (4) | 23 (9) |
6 | 1576 | 141 (9) | 16 (11) | 8 (6) | 8 (6) |
7 | 450 | 143 (32) | 16 (11) | 8 (6) | 8 (6) |
8 | 860 | 132 (15) | 8 (6) | 2 (2) | 6 (5) |
Total | 11341 | 2586 (23) | 415 (16) | 108 (4) | 307 (12) |
Table 2 Donor age, MELD score, and outcomes in patients undergoing liver retransplantation for hepatitis C virus recurrence with undetectable hepatitis C virus viremia before liver retransplantation
reLT donor age (yr) | reLT MELD score | Outcome |
14 | 35 | Alive |
19 | 22 | Deceased |
20 | 24 | Alive |
23 | 16 | Alive |
24 | 25 | Alive |
31 | 17 | Alive |
35 | 23 | Alive |
46 | 33 | Deceased |
47 | 38 | Alive |
52 | 26 | Alive |
58 | 21 | Alive |
60 | 28 | Alive |
62 | 14 | Alive |
Table 3 Univariate analysis of qualitative variables associated with survival in retransplanted patients for hepatitis C virus recurrence
Risk factor | n | Survival estimation | Log-rank P value | ||
3 yr | 5 yr | 10 yr | |||
HIV serology | |||||
Negative | 104 | 57% | 49% | 45% | 0.006 |
Positive | 4 | 0% | |||
IS after LT1 | |||||
Without MMF | 82 | 58% | 51% | 47% | 0.060 |
With MMF | 26 | 45% | 33% | 0% | |
Genotype 1 | |||||
No | 23 | 69% | 69% | 69% | 0.110 |
Yes | 69 | 55% | 45% | 41% | |
HCV viremia pre-reLT | |||||
Negative | 14 | 86% | 86% | 86% | 0.005 |
Positive | 94 | 50% | 41% | 36% | |
Dialysis pre-reLT | |||||
Yes | 19 | 74% | 67% | 67% | 0.060 |
No | 89 | 51% | 43% | 37% | |
Split graft at reLT | |||||
No | 101 | 57% | 48% | 44% | 0.060 |
Yes | 7 | 29% | 29% | 0% | |
IS after reLT | |||||
With tacrolimus | 62 | 67% | 57% | 53% | 0.038 |
Without tacrolimus | 41 | 43% | 37% | 30% | |
Antiviral therapy post-reLT | |||||
Yes | 35 | 85% | 75% | 64% | 0.0003 |
No | 63 | 44% | 36% | 36% | |
Antiviral response post-reLT | |||||
SVR | 14 | 93% | 93% | 93% | 0.039 |
Partial or NR | 18 | 77% | 59% | 43% | |
FCH post-LT1 | |||||
No | 90 | 59% | 52% | 49% | 0.018 |
Yes | 18 | 34% | 23% | 0% | |
Arterial complications post-reLT | 0.030 | ||||
No | 90 | 62% | 53% | 48% | |
Yes | 11 | 27% | 27% | 27% | |
Andres score > 40 | |||||
No | 35 | 71% | 64% | 64% | 0.019 |
Yes | 67 | 49% | 40% | 37% | |
Reinscription MELD < 25 | 0.026 | ||||
No | 30 | 39% | 34% | 34% | |
Yes | 72 | 66% | 58% | 51% |
Table 4 Univariate analysis of quantitative variables associated with survival in retransplanted patients for hepatitis C virus recurrence
Risk factor | Hazard ratio | 95%CI | P value |
Less days under MV pre-reLT | 1.25 | 1.02-1.52 | 0.031 |
Lower reLT donor age | 1.02 | 1.00-1.04 | 0.017 |
Lower recipient age at LT1 | 1.04 | 1.00-1.08 | 0.027 |
Greater interval between LT1 and reLT | 0.88 | 0.82-0.96 | 0.002 |
Table 5 Factors associated with survival according to multivariate analysis in patients undergoing liver retransplantation for hepatitis C virus recurrence, adjusted for center effect and fibrosing cholestatic hepatitis occurrence
Risk factor | Hazard ratio | 95%CI | P value |
Undetectable HCV viremia pre-reLT | 8.80 | 1.96-39.39 | 0.004 |
Receipt of antiviral treatment after reLT | 4.98 | 2.23-11.15 | < 0.0001 |
ReLT donor age < 60 yr | 3.54 | 1.42-8.82 | 0.007 |
Non-genotype 1 | 3.94 | 1.35-11.57 | 0.010 |
Reinscription MELD ≤ 25 | 2.45 | 1.23-4.88 | 0.010 |
Table 6 Survival estimation according to the presence of each of the independent mortality risk factors
RT inscription MELD > 25 | Genotype 1 | RT donor age > 60 yr | No antiviral treatment post-RT | HCV viremia pre-RT | Number of factors | Survival | ||
1 yr | 3 yr | 5 yr | ||||||
- | - | - | - | - | 0 | 99.7% | 99.5% | 99.3% |
+ | - | - | - | - | 1 | 99.1% | 98.7% | 98.3% |
- | + | - | - | - | 98.8% | 98.1% | 97.2% | |
- | - | + | - | - | 99.0% | 97.9% | 97.0% | |
- | - | - | + | - | 98.6% | 97.7% | 96.8% | |
- | - | - | - | + | 98.0% | 96.2% | 94.8% | |
+ | + | - | - | - | 2 | 97.4% | 95.3% | 94.6% |
+ | - | + | - | - | 97.7% | 95.9% | 94.3% | |
+ | - | - | + | - | 96.9% | 95.1% | 93.2% | |
- | + | + | - | - | 96.0% | 93.4% | 90.8% | |
+ | - | - | - | + | 95.3% | 91.7% | 88.3% | |
- | + | - | + | - | 94.8% | 91.3% | 87.9% | |
- | - | + | + | - | 94.8% | 90.7% | 87.3% | |
- | + | - | - | + | 91.3% | 85.9% | 81.0% | |
- | - | + | - | + | 91.3% | 85.7% | 79.6% | |
- | - | - | + | + | 87.0% | 79.4% | 71.2% | |
+ | + | + | - | - | 3 | 92.3% | 87.8% | 83.2% |
+ | + | - | + | - | 89.4% | 82.5% | 76.4% | |
+ | + | - | - | + | 83.2% | 73.1%1 | 63.9% | |
+ | - | + | - | + | 82.5% | 72.1% | 63.1% | |
- | + | + | + | - | 82.0% | 71.2% | 61.9% | |
+ | - | - | + | + | 75.2% | 61.4% | 50.3% | |
+ | - | + | + | - | 72.5% | 58.1% | 47.0% | |
- | + | + | - | + | 71.1% | 56.3% | 44.5% | |
- | + | - | + | + | 61.2% | 42.7% | 30.2% | |
- | - | + | + | + | 59.9% | 41.6% | 28.5% | |
+ | + | + | + | - | 4 | 67.2% | 50.5% | 37.9% |
+ | + | + | - | + | 52.0% | 32.4% | 20.1% | |
+ | + | - | + | + | 36.9% | 18.1%1 | 8.9% | |
+ | - | + | + | + | 35.7% | 17.1% | 8.3% | |
- | + | + | + | + | 17.0% | 4.5% | 1.5% | |
+ | + | + | + | + | 5 | 2.8% | 0.3% | 0.0% |
- Citation: Song ATW, Sobesky R, Vinaixa C, Dumortier J, Radenne S, Durand F, Calmus Y, Rousseau G, Latournerie M, Feray C, Delvart V, Roche B, Haim-Boukobza S, Roque-Afonso AM, Castaing D, Abdala E, D’Albuquerque LAC, Duclos-Vallée JC, Berenguer M, Samuel D. Predictive factors for survival and score application in liver retransplantation for hepatitis C recurrence. World J Gastroenterol 2016; 22(18): 4547-4558
- URL: https://www.wjgnet.com/1007-9327/full/v22/i18/4547.htm
- DOI: https://dx.doi.org/10.3748/wjg.v22.i18.4547