Hepatitis C virus recurrence after liver transplantation is almost universal, but the natural history of recurrent Hepatitis C virus in the allograft is highly variable.
Dr Speranta Iacob and colleagues assessed the impact of different pre- and posttransplantation factors on graft and patient survival in Hepatitis C virus transplant recipients.
|The area under receiver operating characteristic curve was 0.8|
The team of doctors also created a model to predict the patients at risk for Hepatitis C virus-related graft cirrhosis at 5 years posttransplantation.
The team considered a total of 168 transplantations for this study.
Univariate and multivariate Cox proportional hazards regression model was used.
The team used logistic regression analysis to create a model of prediction of Hepatitis C virus cirrhosis within 5 years after transplantation.
The doctors found that predictive factors for decreased graft and patient survival included patients recently transplanted, and induction without azathioprine.
Short-term therapy with mycophenolate mofetil and prednisone were both predictive of decreased graft and patient survival.
In addition, the doctors noted that presence of early cholestasis, and histologically proven early recurrence of Hepatitis C decreased graft and patient survival.
Recipient human leukocyte antigen DR3 positivity, presence of early homeostasis, and donor age over 50 were independent predictors of graft cirrhosis within 5 years.
A predictive model was established in order to calculate at 6 months a risk score for graft Hepatitis C virus cirrhosis within 5 years posttransplantation.
The team used a formula that included the identified independent predictors.
The area under receiver operating characteristic curve was 0.8, indicating a good ability to predict medium-term Hepatitis C virus allograft cirrhosis.
Dr Iacob's team concluded, "This model may be a useful tool for better identifying high-risk Hepatitis C virus patients who should be selected for early initiation of antiviral therapy."