The researchers conducted an analysis of the causes of death in long-term survivors of orthotopic liver transplantation (OLT), and reported their findings in the September issue of Liver Transplantation.
They reviewed the causes of death among 299 adult liver transplant recipients who survived more than 3 years after OLT at 2 centers.
Of these transplant recipients, 38 subsequently died.
Non-hepatic causes accounted for 58% of the 38 late deaths.
Death caused by malignancies occurred in 9 patients between 3.3 and 8.0 years after OLT. Some 8 patients died of cardiovascular complications. The 6 patients who died of myocardial infarction had risk factors for coronary artery disease.
Hepatic failure caused by recurrent liver disease or chronic rejection accounted for 16 of 38 late deaths (42%). These 16 patients were younger than patients who died of non-hepatic complications (mean ages, 51 vs 62 years).
|58% of late deaths after OLT were due to non-hepatic causes.|
However, the mean interval between OLT and death was similar among patients who died of non-hepatic versus hepatic causes.
The researchers found that 9 patients had recurrent liver disease leading to death, and 8 of 9 patients had recurrent chronic hepatitis C virus (HCV) infection.
Chronic rejection resulting in graft failure and death occurred in 7 patients.
Author Jatinder Pruthi, of the Southern California Permanente Medical Group, said on behalf of the group, "De novo malignancies and cardiovascular complications accounted for more than half the late deaths after liver transplantation.
"Patients who died of non-hepatic causes were significantly older than patients who died of hepatic causes."
"Chronic rejection and recurrent HCV infection accounted for the majority of hepatic causes of death.
"With longer follow-up, graft failure resulting from recurrent HCV infection will become the major cause of death in late survivors," it was concluded.