Older donor livers show early severe histological activity, fibrosis, and graft failure after liver transplantation for hepatitis C

Stephen C RAYHILL; You Min Wu; Warren N SCHMIDT; Daniel A KATZ; Michael D VOIGT; Douglas R LABRECQUE; Patricia A KIRBY; Frank A MITROS; Roberto S KALIL; Rachel A MILLER; Alan H STOLPEN

doi:10.1097/01.tp.0000270313.31328.63

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Older donor livers show early severe histological activity, fibrosis, and graft failure after liver transplantation for hepatitis C

Journal article

Peer reviewed

Older donor livers show early severe histological activity, fibrosis, and graft failure after liver transplantation for hepatitis C

Stephen C RAYHILL, You Min Wu, Warren N SCHMIDT, Daniel A KATZ, Michael D VOIGT, Douglas R LABRECQUE, Patricia A KIRBY, Frank A MITROS, Roberto S KALIL, Rachel A MILLER, …

Transplantation, Vol.84(3), pp.331-339

2007

DOI: 10.1097/01.tp.0000270313.31328.63

PMID: 17700157

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Abstract

Background. In hepatitis C virus (HCV)-positive liver transplant recipients, infection of the allograft and recurrent liver disease are important problems. Increased donor age has emerged as an important variable affecting patient and graft survival; however, specific age cutoffs and risk ratios for poor histologic outcomes and graft survival are not clear. Methods. A longitudinal database of all HCV-positive patients transplanted at our center during an 11-year period was used to identify 111 patients who received 124 liver transplants. Graft survival and histological endpoints (severe activity and fibrosis) of HCV infection in the allografts were compared as a function of donor age at transplantation. Results. By Kaplan-Meier analyses, older allografts showed earlier failure and decreased time to severe histological activity and fibrosis as compared with allografts from younger donors. By Cox proportional hazards analysis, older allografts were at greater risk for all severe histologic features and decreased graft survival as compared with younger allografts (P≤0.02 for all outcomes). Analysis of donor age as a dichotomous variable showed that donors greater than 60 yr were at high risk for deleterious histologic outcomes and graft failure. An age cutoff of 60 yr showed a sensitivity of 94% and specificity of 67% for worse graft survival by receiver operating characteristics curve. Conclusions. Advanced donor age is associated with more aggressive recurrent HCV and early allograft failure in HCV-positive liver transplant recipients. Consideration of donor age is important for decisions regarding patient selection, antiviral therapy, and organ allocation.

Fundamental and applied biological sciences. Psychology

Gastroenterology. Liver. Pancreas. Abdomen

Fundamental immunology

Tissue, organ and graft immunology

Liver. Biliary tract. Portal circulation. Exocrine pancreas

Biological and medical sciences

Medical sciences

Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases

Other diseases. Semiology

Details

Title: Subtitle: Older donor livers show early severe histological activity, fibrosis, and graft failure after liver transplantation for hepatitis C
Creators: Stephen C RAYHILL - Department of Surgery, Roy J. and Lucille A. Carver College of Medicine, University of Iowa and Veterans Administration Medical Center, Iowa City, IA, United States
You Min Wu - Department of Surgery, Roy J. and Lucille A. Carver College of Medicine, University of Iowa and Veterans Administration Medical Center, Iowa City, IA, United States
Warren N SCHMIDT - Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa and Veterans Administration Medical Center, Iowa City, IA, United States
Daniel A KATZ - Department of Surgery, Roy J. and Lucille A. Carver College of Medicine, University of Iowa and Veterans Administration Medical Center, Iowa City, IA, United States
Michael D VOIGT - Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa and Veterans Administration Medical Center, Iowa City, IA, United States
Douglas R LABRECQUE - Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa and Veterans Administration Medical Center, Iowa City, IA, United States
Patricia A KIRBY - Department of Pathology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa and Veterans Administration Medical Center, Iowa City, IA, United States
Frank A MITROS - Department of Pathology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa and Veterans Administration Medical Center, Iowa City, IA, United States
Roberto S KALIL - Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa and Veterans Administration Medical Center, Iowa City, IA, United States
Rachel A MILLER - Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa and Veterans Administration Medical Center, Iowa City, IA, United States
Alan H STOLPEN - Department of Radiology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa and Veterans Administration Medical Center, Iowa City, IA, United States
Resource Type: Journal article
Publication Details: Transplantation, Vol.84(3), pp.331-339
Publisher: Lippincott; Hagerstown, MD
DOI: 10.1097/01.tp.0000270313.31328.63
PMID: 17700157
ISSN: 0041-1337
eISSN: 1534-6080
Language: English
Date published: 2007
Academic Unit: Radiology; Gastroenterology and Hepatology; Pathology; Surgery; Internal Medicine
Record Identifier: 9984051741202771

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