Positive serum cryoglobulin is associated with worse outcome after liver transplantation for chronic hepatitis C

Stephen C RAYHILL; Patricia A KIRBY; Dennis HEISEY; You Min Wu; Warren N SCHMIDT; Michael D VOIGT; Douglas R LA BRECQUE; Charles T LUTZ; Daniel A KATZ; Frank A MITROS; Roberto S KALIL; Rachel A MILLER; Alan H STOLPEN

doi:10.1097/01.TP.0000164826.84041.F0

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Positive serum cryoglobulin is associated with worse outcome after liver transplantation for chronic hepatitis C

Journal article

Peer reviewed

Positive serum cryoglobulin is associated with worse outcome after liver transplantation for chronic hepatitis C

Stephen C RAYHILL, Patricia A KIRBY, Dennis HEISEY, You Min Wu, Warren N SCHMIDT, Michael D VOIGT, Douglas R LA BRECQUE, Charles T LUTZ, Daniel A KATZ, Frank A MITROS, …

Transplantation, Vol.80(4), pp.448-456

2005

DOI: 10.1097/01.TP.0000164826.84041.F0

PMID: 16123717

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Abstract

Background. Recurrent hepatitis C virus (HCV) infection in patients after liver transplantation is an important clinical problem. Because serum cryoglobulins (CG) are known to be associated with an increased incidence of cirrhosis in nontransplant patients, the authors tested the hypothesis that CG would also predict aggressive recurrent HCV in patients after liver transplantation. Methods. Using a longitudinal database, the outcomes of 105 allografts transplanted into 97 HCV-positive patients from 1991 through 2002 were analyzed on the basis of CG status using a retrospective cohort design. Fifty-nine CG-negative and 38 CG-positive patients were identified. Histologic outcomes and graft survival were analyzed using Kaplan-Meier estimates and Cox univariate and multivariate analyses. Both overall survival and HCV-specific survival (non–HVC-related deaths and graft losses censored) were analyzed. Results. By Kaplan-Meier estimates, CG-positive patients showed earlier graft failure with decreased time to severe histologic activity and fibrosis as compared with CG-negative patients (P<0.05 for all outcomes). By univariate analysis, CG-positive patients had significantly higher risk ratios for shortened HCV-specific graft survival, severe activity-free survival, and severe fibrosis-free survival as compared with CG-negative patients (P<0.05 for all outcomes). In the multivariate model, CG was an independent predictor for severe activity-free, severe fibrosis-free, and HCV-specific graft survival (P<0.05 for all outcomes). Conclusions. CG-positivity is associated with severe recurrent HCV disease in liver transplant recipients.

Infectious Diseases

Fundamental and applied biological sciences. Psychology

Fundamental immunology

Viral hepatitis

Tissue, organ and graft immunology

Viral diseases

Biological and medical sciences

Medical sciences

Human viral diseases

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

Details

Title: Subtitle: Positive serum cryoglobulin is associated with worse outcome after liver transplantation for chronic hepatitis C
Creators: Stephen C RAYHILL - Department of Surgery, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, United States
Patricia A KIRBY - Department of Pathology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, United States
Dennis HEISEY - Department of Surgery and Statistics, College of Medicine, University of Wisconsin, Madison, WI, United States
You Min Wu - Department of Surgery, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, United States
Warren N SCHMIDT - Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, United States
Michael D VOIGT - Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, United States
Douglas R LA BRECQUE - Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, United States
Charles T LUTZ - Department of Pathology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, United States
Daniel A KATZ - Department of Surgery, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, United States
Frank A MITROS - Department of Pathology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, United States
Roberto S KALIL - Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, United States
Rachel A MILLER - Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, United States
Alan H STOLPEN - Department of Radiology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, United States
Resource Type: Journal article
Publication Details: Transplantation, Vol.80(4), pp.448-456
Publisher: Lippincott; Hagerstown, MD
DOI: 10.1097/01.TP.0000164826.84041.F0
PMID: 16123717
ISSN: 0041-1337
eISSN: 1534-6080
Language: English
Date published: 2005
Academic Unit: Radiology; Gastroenterology and Hepatology; Pathology; Surgery; Internal Medicine
Record Identifier: 9984051883502771

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