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Mild donor liver steatosis has no impact on hepatitis C virus fibrosis progression following liver transplantation
Author(s) -
Botha Jean F.,
Thompson Eric,
Gilroy Richard,
Grant Wendy J.,
Mukherjee Sandeep,
Lyden Elizabeth R.,
Fox Ira J,
Sudan Debra L.,
Shaw Byers W.,
Langnas Alan N.
Publication year - 2007
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2007.01490.x
Subject(s) - medicine , steatosis , gastroenterology , liver transplantation , cirrhosis , proportional hazards model , hepatitis c , hazard ratio , hepatitis c virus , fibrosis , transplantation , fatty liver , disease , confidence interval , immunology , virus
Background: This study examines the impact of donor liver macrovesicular steatosis on recurrence of hepatitis C virus (HCV) disease after liver transplantation. Methods: Between 1998 and 2004, 113 patients underwent liver transplantation for HCV‐related cirrhosis. Time to histologic recurrence (fibrosis score ≥2) was the primary endpoint of the study. Recurrence was graded according to the system of Ludwig and Batts. A Cox's proportional hazard regression model was used to analyse the association between donor liver steatosis and HCV recurrence. Results: Recurrence‐free survival for patients who received steatotic grafts was 82% and 47% at 1 and 4 years, respectively, and 81% and 52% for patients who received a non‐steatotic liver. Donor macrovesicular steatosis (5–45%) was found to have no impact on HCV recurrence ( P =0.47). Donor age ( P =0.02) and cold ischaemia time ( P =0.01) were found to increase the relative risk of HCV recurrence. The estimated risk of HCV recurrence increased by 23% for every 10‐year increase in donor age. Similarly the risk of recurrence increased by 13% for every 1‐h increase in cold ischaemia time. Conclusion: Mild‐moderate donor liver macrovesicular steatosis has no impact on HCV recurrence after liver transplantation for HCV‐related cirrhosis. Cold ischaemia time and donor age increased the likelihood of HCV recurrence.