TY - JOUR
T1 - Results of live donor liver transplantation in patients with hepatitic C virus infection
T2 - The HCV 3 trial experience
AU - Sher, Linda
AU - Jennings, Linda
AU - Rudich, Steven
AU - Alexopoulos, Sophoclis P.
AU - Netto, George
AU - Teperman, Lewis
AU - Kinkhabwala, Milan
AU - Brown, Robert S.
AU - Pomfret, Elizabeth
AU - Klintmalm, Goran
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2012/5
Y1 - 2012/5
N2 - Chronic hepatitis C virus (HCV) is the most common disease indication for liver transplantation (LT). Outcomes are compromised by near universal recurrence of HCV. A prospective multi-center randomized study to evaluate immunosuppressive strategies in HCV+ transplant recipients provided the opportunity to assess impact of live donor (LD) LT. Two hundred and ninety-five patients undergoing LT for HCV (260 deceased donor [DD] recipients/35 LD recipients), randomized to three regimens, were followed for twoyr for patient and graft survival and rate and severity of recurrent HCV. Biopsies were performed at baseline, 3, 12, and 24months. One- and two-yr patient survival for LD recipients was 88.1% and 81.1% vs. 90.5% and 84.6% for DD recipients (p=0.5665). One- and two-yr graft survival for LD recipients was 82.9% and 76.2% vs. 87.9% and 81.7% for DD recipients (p=0.3921). Recurrent HCV did not account for more deaths or graft losses in the LD recipients. In this prospective study, controlled for immunosuppression, use of LD organs did not increase the rate or severity of HCV recurrence. The more elective nature of LDLT affords an opportunity to manipulate donor and recipient factors that can impact upon outcomes.
AB - Chronic hepatitis C virus (HCV) is the most common disease indication for liver transplantation (LT). Outcomes are compromised by near universal recurrence of HCV. A prospective multi-center randomized study to evaluate immunosuppressive strategies in HCV+ transplant recipients provided the opportunity to assess impact of live donor (LD) LT. Two hundred and ninety-five patients undergoing LT for HCV (260 deceased donor [DD] recipients/35 LD recipients), randomized to three regimens, were followed for twoyr for patient and graft survival and rate and severity of recurrent HCV. Biopsies were performed at baseline, 3, 12, and 24months. One- and two-yr patient survival for LD recipients was 88.1% and 81.1% vs. 90.5% and 84.6% for DD recipients (p=0.5665). One- and two-yr graft survival for LD recipients was 82.9% and 76.2% vs. 87.9% and 81.7% for DD recipients (p=0.3921). Recurrent HCV did not account for more deaths or graft losses in the LD recipients. In this prospective study, controlled for immunosuppression, use of LD organs did not increase the rate or severity of HCV recurrence. The more elective nature of LDLT affords an opportunity to manipulate donor and recipient factors that can impact upon outcomes.
KW - Hepatitis C
KW - Live donor liver transplant
KW - Liver transplantation
KW - Outcomes
KW - Recurrence
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U2 - 10.1111/j.1399-0012.2011.01561.x
DO - 10.1111/j.1399-0012.2011.01561.x
M3 - Article
C2 - 22151078
AN - SCOPUS:84862249740
SN - 0902-0063
VL - 26
SP - 502
EP - 509
JO - Clinical Transplantation
JF - Clinical Transplantation
IS - 3
ER -