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Liver transplantation for familial amyloidotic polyneuropathy: Impact on Swedish patients' survival
Author(s) -
Okamoto Sadahisa,
Wixner Jonas,
Obayashi Konen,
Ando Yukio,
Ericzon BoGöran,
Friman Styrbjörn,
Uchino Makoto,
Suhr Ole B.
Publication year - 2009
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.21817
Subject(s) - medicine , liver transplantation , polyneuropathy , disease , transplantation , age of onset , liver disease , gastroenterology , surgery , pediatrics
Liver transplantation (LTx) for familial amyloidotic polyneuropathy (FAP) is an accepted treatment for this fatal disease. However, the long‐term outcome with respect to that of nontransplanted patients has not been fully elucidated. The aim of this study was to compare the long‐term survival of Swedish LTx FAP patients with that of historical controls, especially with respect to the age at onset of the disease and gender. In order to evaluate the outcome of LTx as a treatment for FAP, survival was calculated from the onset of disease. One hundred forty‐one FAP patients, 108 transplanted and 33 not transplanted, were included in the study. Significantly increased survival was noted for LTx patients in comparison with controls. The outcome was especially favorable for those with an early onset of the disease (age at onset < 50 years) in comparison with early‐onset controls ( P < 0.001). In contrast, no significant difference for late‐onset cases (≥50 years) was found. Transplanted late‐onset females had significantly improved survival in comparison with transplanted late‐onset males ( P = 0.02). We were unable to find significant differences in survival between patients with long (≥7 years) or short (<7 years) disease duration at transplantation. The survival of male patients with late‐onset disease appeared not to improve with LTx. LTx is an efficacious treatment for improving the survival of early‐onset FAP patients. Further studies are needed to analyze the cause of the poorer outcome for late‐onset male patients. Liver Transpl 15:1229–1235, 2009. © 2009 AASLD.