Survival Outcome after Early and Late Hepatic Re-Transplantation (Re-LT) for HCV(+) and HCV(-) Patients
(2010) 16th Annual Congress of the International-Liver-Transplantation-Society — Location: Hong Kong (China) (16.June.2010)
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- (en) AIM: Compare the outcome of patients who underwent early (≤ 3 months ) and late (> 3 months after LT) re-LT in HCV(+) and HCV(-) patients (pts) in a single center retrospective study. METHODS AND MATERIAL: From February 1984 to July 2009, 895 LT were performed in 789 adults (≥ 16 yrs) in our center. Ninety-eight (12,4%) pts needed a second graft, 21 pts were HCV(+) and 77 pts were HCV(-). In the HCV(+) group, 12 pts underwent early and 9 pts late re-LT, in the HCV(-) pts, 41 pts and 36 pts needed early and late re-LT. Demographic data, clinical scores,second graft and patient survival of both groups were compared and analysed. RESULTS: HCV(+) pts were significantly older than HCV(-) pts (52,6± 9,5 vs 42,4±15,1 yrs) (p=0,004). Hepatocellular cancer was present in 20% of the HCV(+) pts and in 25% of the HCV(-) pts (ns). Mean time of late re-LT in HCV(+) and HCV(-) were 52,26±34,1 and 36,72±46,6 mo resp. (p=0,35). Mean follow-up was 69 mo (0,07 to 225). Main indications for early re-LT in HCV(+) and HCV(-) pts were graft dysfunction (7/12 and 23/41 resp.). Indications of late Re-LT in HCV(+) pts were HCV recurrence (7pts), ischemic type biliary lesion (ITBL) (1 pat) and HBV related cirrhosis (1 pat). ITBL was the main indication of late re-LT in the 19 HCV(-) pts, followed by chronic rejection in 10 pts. Actuarial 1-year patient survival rates after early re-LT for HCV(+) and HCV (-) pts. were 75% and 58% resp. (p=0,50). Actuarial and 1-year patient survival rates after late Re-OLT for HCV(+) and HCV(-) pts. were 89% and 83% resp. (ns). Actuarial and 5-year patient survival rates after early re-LT for HCV(+) and HCV (-) pts were 58% and 41% resp.(p=0,51). Actuarial and 5-year patient survival rates after late re-LT for HCV(+) and HCV(-) pts were 57% and 69% resp. (p=0,71). Six HCV(-) and only 1 pat. in the HCV(+) all needed a late second re-LT because ITBL. CONCLUSION: In these series re-LT in HCV(+) pts had comparable early and long term results to HCV(-) pts as well in case of early as late re-LT. Retransplantation remains a valuable treatment option in HCV(+) pts having both early graft dysfunction and allograft viral recurrence.
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Bonaccorsi Riani, E., Ciccarelli, O., Ciccarelli, O., De Reyck, C., Lerut, J., Hassoun, Z., Kabamba-Mukadi, B., Sempoux, C., & Lerut, J. (2010). Survival Outcome after Early and Late Hepatic Re-Transplantation (Re-LT) for HCV(+) and HCV(-) Patients. Liver Transplantation, 16(Suppl 1), S145. https://hdl.handle.net/2078.5/210477 (Original work published 2010)