Survival for non-hep C-related liver transplants

The most recent issue of Liver Transplantation finds Improved long-term survival for non-hepatitis C-related adult liver transplant patients.

Although 1-year survival rates following liver transplantation over the last 20 years may have improved, there is doubt about improvement in long-term survival.

Dr Geoffrey McCaughan and colleagues from Australia examined survival with and without initial 12-month mortality in adult liver transplant recipients over a 20-year period.

The team compared patient and allograft survival for 3 different time periods was compared.

Group 1 included 547 patients from 1986 to 1994, Group 2 included 735 patients from 1995 to 2000, and Group 3 included 749 patients between 2000 and 2005.

The team recorded all deaths in the first 12 months of each group.

There were more deaths due to recurrent hep C virus

Liver Transplantation

Patient and allograft survival was then once again compared across the 3 groups.

There was significant improvement in both patient and allograft survival across the 20-year period.

The researchers found that overall patient and allograft survival improved in non-hepatitis C virus patients but not in hepatitis C virus patients.

A similar comparison with deaths in the first year removed, however, showed no difference in patient survival.

The team noted only a marginal improvement in allograft survival between the 3 time periods.

When patients were divided into hepatitis C virus-positive and hepatitis C virus-negative groups with deaths in the first year removed.

There was improved patient and allograft survival in the non-hepatitis C virus-negative group but not in the hepatitis C virus-positive group.

The causes of death between 1 and 5 years were then compared.

There were 48 deaths in period 1, 63 in period 2, and 43 in period 3.

The research team found that were more deaths due to cardio/cerebrovascular disease and hepatitis B virus recurrence in the first time period.

The team observed more deaths due to recurrent hepatitis C virus, and de novo malignancy in later time periods.

Dr McCaughan's team concluded, “Although overall survival following liver transplantation in adults seems to be improving over time, the long-term results are not, particularly in hepatitis C virus patients.”