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Dig Dis Sci. 2013 May;58(5):1403-9. doi: 10.1007/s10620-012-2521-9. Epub 2013 Jan 10.

Hepatic preservation injury: severity of hepatitis C recurrence and survival after liver transplantation.

Author information

1
Division of Gastroenterology and Hepatology, The Ohio State University Medical Center, 395W 12th Ave, Suite 200, Columbus, OH 43210, USA. Anthony.Michaels@osumc.edu

Abstract

BACKGROUND:

Preservation injury in the HCV liver transplant population has been reported to correlate with poorer survival outcomes compared to preservation injury in the non-HCV liver transplant population. However, determinants of progression to cirrhosis in HCV infection remain poorly defined in this population.

AIM:

This study aimed to determine if the presence and severity of preservation injury impact the acceleration of HCV recurrence and survival after liver transplant.

METHODS:

We retrospectively reviewed liver transplant HCV patients over a 10-year period. Biopsies from postoperative day 7 were assessed for preservation injury and 4- and 12-month biopsies were assessed for fibrosis. Patients with Ishak fibrosis >0.8 Units/year were considered rapid fibrosers.

RESULTS:

Our study group consisted of 255 patients. The mean age was 49.3 years old, 180 (70.6 %) were male, and 221 (86.7 %) were Caucasian. The incidence of preservation injury on the 7-day biopsy was 69.0 %. A strong correlation between postoperative peak AST within the first week and preservation injury was found. The overall prevalence of rapid fibrosers at 4 months, 1 and 2 years was 47.4, 75.2, and 58.9 %, respectively. The prevalence of rapid fibrosers at 4 months, 1 and 2 years between patients with or without preservation injury was not statistically significant (p = 0.39, p = 0.46, and p = 0.53, respectively). No differences were seen between patients with and without PI in terms of patient and graft survival.

CONCLUSION:

In this study, the presence and severity of preservation injury were not associated with development of rapid HCV recurrence or worsening in survival.

PMID:
23306846
PMCID:
PMC3665404
DOI:
10.1007/s10620-012-2521-9
[Indexed for MEDLINE]
Free PMC Article

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