Factors Differentially Correlated With the Outcome of Liver Transplantation in Hcv+ and HCV- Recipients

Abstract

A number of parameters are differentially correlated with outcome in HCV- and HCV+ recipients of orthotopic liver transplantation. These findings may not only have practical implications in the selection and management of liver transplant patients, but also may shed new insight into the biology of HCV infection posttransplant.

Liver Transplantation in the Ethnic Minority Population: Challenges and Prospects

“…Charlton et al [32] identified recipient race as a predictor in the HCV subgroup. Similarly, Velidedeoglu et al [33] found recipient race was an independent predictor of survival in recipients with HCV. There was no significant difference in survival for non-HCV recipients based on ethnicity, suggesting that the disparity in survival observed in African Americans may be related to the presence of hepatitis C. In view of the fact that sustained virologic response (SVR) to interferon-based therapy is associated with lower mortality in transplant recipients [34], the decreased survival may, in part, be related to the decreased response rates in African Americans.…”

Diabetes Mellitus Increases the Risk of Mortality Following Liver Transplantation Independent of MELD Score

“…With these additional sources of mortality associated with pre-existing DM and an increasing global incidence and high prevalence of DM in liver failure populations, understanding the effects of preexisting DM is important in maximizing the benefit derived from LT. Studies have examined the effect of pre-existing DM on survival after LT with center-specific studies showing mixed results (Table 2) [5,[13][14][15][16][17][18]. One United Network for Organ Sharing (UNOS) database review found that type I, but not type II, DM was an independent predictor of poor late outcome, while another UNOS review found DM as an independent predictor of late mortality only in HCV-positive patients [19,20]. Early reviews by both Wahlstrom et al [14] and Trail et al [15] found no significant difference in outcomes between diabetics and non-diabetics, but these studies pre-dated the use of MELD scores for the allocation of deceased donor livers, which was initiated in February 2002.…”

“…The role of pretransplant diabetes mellitus (DM) as a risk factor for poor survival after LT has been examined, with some studies showing a higher mortality in diabetic patients and others showing no difference in survival between diabetics and non-diabetics [5,[13][14][15][16][17][18][19][20]. None of the studies directly assessed the severity of pretransplant liver disease, as determined by the Model for End-stage Liver Disease (MELD) score.…”

Insulin Resistance, Serum Adipokines and Risk of Fibrosis Progression in Patients Transplanted for Hepatitis C

“…Furthermore, diabetes mellitus has been shown to be a risk factor for graft loss (4) and mortality (5) in liver transplant patients with chronic HCV infection. (6).…”