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No Improvement in Long‐Term Liver Transplant Graft Survival in the Last Decade: An Analysis of the UNOS Data
Author(s) -
Futagawa Y.,
Terasaki P. I.,
Waki K.,
Cai J.,
Gjertson D. W.
Publication year - 2006
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2006.01256.x
Subject(s) - medicine , hepatitis c virus , cirrhosis , hepatitis c , liver transplantation , survival analysis , united network for organ sharing , surgery , survival rate , gastroenterology , transplantation , virus , immunology
We analyzed change in outcomes during two successive 5‐year periods (period I = 1992–1996 vs period II = 1997–2002) among 35 186 deceased adult liver transplant recipients reported to the United Network for Organ Sharing (UNOS) Registry. The 5‐year graft survival was 67.4% in the first period and 67.5% in the second, though the 1‐year survival had improved from 81.0 to 83.5%. Comparison of blended survival rates during the two study periods showed decreased long‐term graft survival in period II, explicable by an increased number of hepatitis C virus cirrhosis (HCV) patients and an increase in patients with HCV antibodies (HCVab) during this later period. Analysis wherein these patients with HCV were excluded revealed the same long‐term graft survival during both periods. Non‐HCV patients who had HCVab also had worse 5‐year graft survival. We conclude that hepatitis C prevented improved outcomes during period II and that improved, more effective, treatment for hepatitis C virus would have great positive impact on overall survival of liver transplant recipients.