Outcomes for Patients with Hepatitis C Virus after Liver Transplantation in Korea.
10.4285/jkstn.2016.30.4.155
- Author:
Jong Man KIM
1
Author Information
1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jongman94@hanmail.net
- Publication Type:Multicenter Study ; Review
- Keywords:
Hepacivirus;
Hepatitis C;
Immunosuppression;
Tacrolimus;
Graft rejection;
Survival;
Antiviral agents
- MeSH:
Antiviral Agents;
Cyclosporine;
Genotype;
Graft Rejection;
Hepacivirus*;
Hepatitis C*;
Hepatitis*;
Hospital Mortality;
Humans;
Immunosuppression;
Korea*;
Liver Diseases;
Liver Transplantation*;
Liver*;
Living Donors;
Recurrence;
Retrospective Studies;
Survival Rate;
Tacrolimus;
Tissue Donors
- From:The Journal of the Korean Society for Transplantation
2016;30(4):155-164
- CountryRepublic of Korea
- Language:English
-
Abstract:
Hepatitis C virus (HCV)-related liver disease is the most common indication for liver transplantation (LT) in Western countries, whereas HCV LT is rare in Korea. We conducted a survey of HCV RNA-positive patients who underwent LT and investigated the prognostic factors for patient survival and the effects of immunosuppression. To accomplish this, we retrospectively reviewed the multicenter records of 192 HCV RNA-positive patients who underwent LT. The 1-, 3-, and 5-year overall survival rates were 78.8%, 75.3%, and 73.1%, respectively. Excluding cases of hospital mortality (n=23), 169 patients were evaluated. Most patients were genotype 1 (n=111, 65.7%) or genotype 2 (n=42, 24.9%). The proportion of living donors for LT (n=135, 79.9%) was higher than that of deceased donors (DDLT; n=34, 20.1%). The median donor and recipient ages were 32 and 56 years, respectively. Twenty-eight patients (16.6%) died during the observation period, while 75 underwent universal prophylaxis and 15 received preemptive therapy. HCV recurrence was detected in 97 patients. Recipients who were older than 60, received DDLT, used cyclosporine, or suffered acute rejection had lower rates of survival. Acute rejection was closely associated with a lack of induction therapy, cyclosporine use, and universal prophylaxis after transplantation. The careful avoidance of acute rejection in the post-transplant period through adequate use of tacrolimus is a preferable strategy that increases patient survival following liver transplantation.
