PMID- 29088255
OWN - NLM
STAT- MEDLINE
DCOM- 20171117
LR  - 20171219
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 10
DP  - 2017
TI  - Liver transplantation for chronic hepatitis C virus infection in the United
      States 2002-2014: An analysis of the UNOS/OPTN registry.
PG  - e0186898
LID - 10.1371/journal.pone.0186898 [doi]
AB  - Chronic hepatitis C virus (HCV) infection is a leading cause for orthotopic liver
      transplantation (OLT) in the U.S. We investigated characteristics of HCV-infected
      patients registered for OLT, and explored factors associated with mortality. Data
      were obtained from the United Network for Organ Sharing and Organ Procurement and
      Transplantation network (UNOS/OPTN) registry. Analyses included 41,157
      HCV-mono-infected patients >/=18 years of age listed for cadaveric OLT between
      February 2002 and June 2014. Characteristics associated with pre- and
      post-transplant survival and time trends over the study period were determined by
      logistic and Cox proportional hazard regression analyses and Poisson regressions.
      Most patients were white (69.1%) and male (70.8%). At waitlist registration, mean
      age was 54.6 years and mean MELD was 16. HCC was recorded in 26.9% of the
      records. A total of 51.2% of the patients received an OLT, 21.0% died or were too
      sick; 15.6% were delisted and 10.4% were still waiting. Factors associated with
      increased waitlist mortality were older age, female gender, blood type 0,
      diabetes, no HCC and transplant region (p<0.001). OLT recipient characteristics
      associated with increased risk for post OLT mortality were female gender, age,
      diabetes, race (p<0,0001), and allocation MELD (p = 0.005). Donor characteristics
      associated with waitlist mortality included age, ethnicity (p<0.0001) and
      diabetes (p<0.03). Waitlist registrations and OLTs for HCC significantly
      increased from 14.4% to 37.3% and 27.8% to 38.5%, respectively (p<0.0001). Pre-
      and post-transplant survival depended on a variety of patient-, donor-, and
      allocation- characteristics of which most remain relevant in the DAA-era. Still, 
      intensified HCV screening strategies and timely and effective treatment of HCV
      are highly relevant to reduce the burden of HCV-related OLTs in the U.S.
FAU - Dultz, Georg
AU  - Dultz G
AD  - University Hospital Frankfurt, Frankfurt am Main, Germany.
FAU - Graubard, Barry I
AU  - Graubard BI
AD  - Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National
      Cancer Institute, Bethesda, MD, United States of America.
FAU - Martin, Paul
AU  - Martin P
AD  - Hepatology Division, University of Miami, Miami, FL, United States of America.
FAU - Welker, Martin-Walter
AU  - Welker MW
AD  - University Hospital Frankfurt, Frankfurt am Main, Germany.
FAU - Vermehren, Johannes
AU  - Vermehren J
AD  - University Hospital Frankfurt, Frankfurt am Main, Germany.
FAU - Zeuzem, Stefan
AU  - Zeuzem S
AD  - University Hospital Frankfurt, Frankfurt am Main, Germany.
FAU - McGlynn, Katherine A
AU  - McGlynn KA
AD  - HREB, Division of Cancer Epidemiology and Genetics, National Cancer Institute,
      Bethesda, MD, United States of America.
FAU - Welzel, Tania M
AU  - Welzel TM
AD  - University Hospital Frankfurt, Frankfurt am Main, Germany.
LA  - eng
PT  - Journal Article
DEP - 20171031
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Aged
MH  - Female
MH  - Hepatitis C, Chronic/mortality/*surgery
MH  - Humans
MH  - Liver Transplantation/*methods/mortality
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment (Health Care)/methods/statistics & numerical data
MH  - Proportional Hazards Models
MH  - Registries/*statistics & numerical data
MH  - Survival Analysis
MH  - Survival Rate
MH  - Tissue and Organ Procurement/*methods
MH  - United States
MH  - Waiting Lists
PMC - PMC5663425
EDAT- 2017/11/01 06:00
MHDA- 2017/11/29 06:00
CRDT- 2017/11/01 06:00
PHST- 2017/08/11 00:00 [received]
PHST- 2017/09/20 00:00 [accepted]
PHST- 2017/11/01 06:00 [entrez]
PHST- 2017/11/01 06:00 [pubmed]
PHST- 2017/11/29 06:00 [medline]
AID - 10.1371/journal.pone.0186898 [doi]
AID - PONE-D-17-29760 [pii]
PST - epublish
SO  - PLoS One. 2017 Oct 31;12(10):e0186898. doi: 10.1371/journal.pone.0186898.
      eCollection 2017.