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Outcomes of orthotopic liver transplantation for hepatic sarcoidosis: An analysis of the United Network for organ sharing/organ Procurement and Transplantation Network data files for a comparative study with cholestatic liver diseases
Author(s) -
Vanatta Jason M.,
Modanlou Kian A.,
Dean Amanda G.,
Nezakatgoo Nosratollah,
Campos Luis,
Nair Satheesh,
Eason James D.
Publication year - 2011
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.22339
Subject(s) - medicine , liver transplantation , sarcoidosis , hazard ratio , univariate analysis , transplantation , united network for organ sharing , primary sclerosing cholangitis , gastroenterology , organ transplantation , multivariate analysis , confidence interval , disease
Hepatic sarcoidosis is a rare indication for liver transplantation. Using the United Network for Organ Sharing (UNOS)/Organ Procurement and Transplantation Network (OPTN) database, we evaluated patient and graft survival after orthotopic liver transplantation for sarcoidosis between October 1987 and December 2007. We assessed the potential prognostic value of multiple demographic and clinical variables, and we also compared these patients to a case‐matched group of patients with primary sclerosing cholangitis (PSC) or primary biliary cirrhosis (PBC). The 1‐ and 5‐year survival rates for the sarcoidosis group were 78% and 61%, respectively, and these rates were significantly worse than the rates for the PSC/PBC group ( P = 0.001). Disease recurrence in the liver is a rare cause of graft loss or patient death. Three deaths occurred in the sarcoidosis group because of recurrent hepatic sarcoidosis, and 1 death was a result of cardiac sarcoidosis. A univariate analysis identified an increasing donor risk index as a significant negative factor for outcomes for the sarcoidosis group [hazard ratio (HR) = 2.06, confidence interval (CI) = 1.04‐4.06, P = 0.037], but this finding was not found in a multivariate analysis, in which no independent predictors were found to have a significant impact. A case‐matched univariate analysis demonstrated that sarcoidosis and morbid obesity were significant negative factors for outcomes, and in a multivariate analysis, sarcoidosis continued to predict worse outcomes (HR = 2.39, CI = 1.21‐4.73, P = 0.012). In conclusion, an analysis of the UNOS/OPTN database indicates that the patient and allograft survival rates for hepatic sarcoidosis are satisfactory, but they are worse in comparison with the rates for other cholestatic liver diseases. Liver Transpl 17:1027–1034, 2011. © 2011 AASLD.