Outcome comparison of liver transplantation for hepatitis A‐related versus hepatitis B‐related acute liver failure in adult recipients

Hepatitis A virus ( HAV ) can cause acute liver failure ( ALF ). This study compares outcomes between liver transplantation ( LT ) for HAV ‐related ALF ( HAV ‐ ALF ) and LT for hepatitis B virus ( HBV )‐related ALF ( HBV ‐ ALF ). Of 3616 adult LT s performed between January 2005 and December 2014, we performed LT for HAV ‐ ALF recipients (n = 29) and LT for HBV ‐ ALF recipients (n = 34). HAV ‐ ALF group included 18 males and 11 females with mean age of 33.1 years. Graft survival rates in HAV ‐ ALF and HBV ‐ ALF were 65.5% and 88.0% (1 year) and 65.5% and 84.0% (5 years) ( P  = .048). Patient survival rates in HAV ‐ ALF and HBV ‐ ALF were 69.0% and 88.0% (1 year) and 69.0% and 84.0% (5 years) ( P  = .09). Multivariate analyses demonstrated that acute pancreatitis and HAV recurrence were independent risk factors of graft and patient survival. Post‐transplant outcome was poorer in patients with HAV ‐ ALF than in those with HBV ‐ ALF . This weakens LT 's appropriateness in HAV ‐ ALF patients with pancreatitis. HAV recurrence after LT for HAV ‐ ALF is common and often fatal; thus, HAV recurrence should be monitored vigilantly, beginning early post‐transplant.