TY - JOUR
T1 - Donor Factors Including Donor Risk Index Predict Fibrosis Progression, Allograft Loss, and Patient Survival following Liver Transplantation for Hepatitis C Virus
AU - Jesudian, Arun
AU - Desale, Sameer
AU - Julia, Jonathan
AU - Landry, Elizabeth
AU - Maxwell, Christopher
AU - Kallakury, Bhaskar
AU - Laurin, Jacqueline
AU - Shetty, Kirti
N1 - Publisher Copyright:
© 2015 INASL
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Background The utilization of liver transplantation (LT) is limited by the availability of suitable organs. This study aimed to assess the impact of the donor risk index (DRI) and other donor characteristics on fibrosis progression, graft, and patient survival in hepatitis C virus (HCV)-infected LT recipients. Methods HCV-infected LT recipients who had at least 2 post-LT protocol liver biopsy specimens available were included. Hazard ratio for bivariate analysis was computed using Cox proportional hazard regression analysis. Results Of 312 recipients, 26.6% died over a median follow-up of 58.5 months (95% CI: 46.5–67.3). Fourteen patients underwent re-transplantation. Mean time to graft failure was 84.3 months, median follow-up: 59 months, 95% CI (48.2, 68.3). DRI >1.5 was significantly associated with patient and graft survival (P = 0.04). Of the subset of 104 individuals who underwent histological analysis, 67.3% progressed to ≥F2. On multivariate analysis, significant donor-specific predictors of fibrosis progression were: donor age >50 years and DRI >1.7. Conclusions (1) Fibrosis progression in HCV-infected LT recipients is strongly associated with donor characteristics, specifically donor age and DRI. (2) DRI, an objective measure of donor quality, appears to correlate both with rate of histological progression and overall patient/graft survival.
AB - Background The utilization of liver transplantation (LT) is limited by the availability of suitable organs. This study aimed to assess the impact of the donor risk index (DRI) and other donor characteristics on fibrosis progression, graft, and patient survival in hepatitis C virus (HCV)-infected LT recipients. Methods HCV-infected LT recipients who had at least 2 post-LT protocol liver biopsy specimens available were included. Hazard ratio for bivariate analysis was computed using Cox proportional hazard regression analysis. Results Of 312 recipients, 26.6% died over a median follow-up of 58.5 months (95% CI: 46.5–67.3). Fourteen patients underwent re-transplantation. Mean time to graft failure was 84.3 months, median follow-up: 59 months, 95% CI (48.2, 68.3). DRI >1.5 was significantly associated with patient and graft survival (P = 0.04). Of the subset of 104 individuals who underwent histological analysis, 67.3% progressed to ≥F2. On multivariate analysis, significant donor-specific predictors of fibrosis progression were: donor age >50 years and DRI >1.7. Conclusions (1) Fibrosis progression in HCV-infected LT recipients is strongly associated with donor characteristics, specifically donor age and DRI. (2) DRI, an objective measure of donor quality, appears to correlate both with rate of histological progression and overall patient/graft survival.
KW - Hepatitis C
KW - donor risk index
KW - liver transplantation
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U2 - 10.1016/j.jceh.2015.10.005
DO - 10.1016/j.jceh.2015.10.005
M3 - Article
C2 - 27493458
AN - SCOPUS:84961152945
SN - 0973-6883
VL - 6
SP - 109
EP - 114
JO - Journal of Clinical and Experimental Hepatology
JF - Journal of Clinical and Experimental Hepatology
IS - 2
ER -