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HCV infection is associated with lower survival in simultaneous liver kidney transplant recipients in the United States
Author(s) -
Perumpail Ryan B.,
Wong Robert J.,
Scandling John D.,
Ha Le Dung,
Todo Tsuyoshi,
Bonham Clark A.,
Saab Sammy,
Younossi Zobair M.,
Ahmed Aijaz
Publication year - 2015
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12598
Subject(s) - medicine , hepatocellular carcinoma , hepatitis c virus , hepatitis c , proportional hazards model , population , liver disease , cohort , liver transplantation , transplantation , kidney disease , gastroenterology , immunology , virus , environmental health
Background The frequency of simultaneous liver kidney transplantation ( SLKT ) has been increasing over the past decade. Hepatitis C virus ( HCV ) infection is the most common indication for liver transplantation in the United States. Given the rising prevalence of HCV ‐related SLKT , it is important to understand the impact of HCV in this patient population. Methods We conducted a retrospective cohort study using data from the United Network for Organ Sharing registry to assess adult patients undergoing SLKT in the United States from 2003 to 2012. Patient survival following SLKT was assessed using Kaplan–Meier methods and multivariate Cox proportional hazards models. Results Patients infected with non‐HCV have significantly lower survival following SLKT compared to non‐ HCV patients at three (three‐yr survival: 71.0% vs. 78.9%, p < 0.01) and five yr (five‐yr survival: 61.4% vs. 72.5%, p < 0.01). The results of multivariate regression analyses demonstrated that patients infected with HCV had significantly lower survival following SLKT than patients with non‐ HCV disease ( HR 1.41, 95% CI , 1.19–1.67, p < 0.001). In addition, lower post‐ SLKT survival was noted among patients with diabetes ( HR 1.34, 95% CI , 1.13–1.58, p < 0.001) and hepatocellular carcinoma ( HR 1.60, 95% CI , 1.17–2.18, p < 0.01). Conclusions Hepatitis C infection is associated with lower patient survival following SLKT .