Effect of Pretransplant Hepatitis C Virus RNA Status on Posttransplant Outcome

C. G. Nudo, R. A. Cortes, D. Weppler, Eugene R Schiff, A. G. Tzakis, A. Regev

Research output: Contribution to journalArticle

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Abstract

Undetectable hepatitis C virus (HCV) RNA [RNA(-)] before liver transplantation (OLT) has been shown to decrease the rates of disease recurrence. We sought to determine whether RNA(-) subjects differ in post-OLT recurrence (virological/VR, histological/HR), graft failure (GF), or patient survival from RNA(+) patients using a retrospective review. From 1995 to 2004, a total of 49 patients were RNA(-) at OLT as a result of interferon-based therapy: 22 SVR and 27 with end-of-treatment response (ETR) transplanted when RNA(-) within 6 months of ET. Forty-eight RNA(+) patients were analyzed as controls. Virological recurrence (VR) was seen in 55% of RNA(-) subjects with no difference in HR between RNA(-) vs (+) groups, namely 36.7% versus 56.3% (P = .068), respectively. The RNA(+) subjects showed a lower time to HR (5.6 vs 11 months; P = .027). The SVR subjects displayed lower VR (36.4%) and histological recurrence (HR) (13.6%) compared to ETR (VR 70.4%, P = .023; HR 55.6%, P = .003) or RNA(+) (HR 56%, P = .0008). The SVR subjects, who were identified with a sensitive assay (SVR(S), lower limit <600 IU/mL) showed no VR, HR, or GF. The 1- and 5-year survivals were 87.8%/75.6% and 89.6%/77.8% for RNA(-) and (+) groups, respectively (P = .77). In conclusion, RNA(-)-transplanted patients displayed lower VR and longer time to HR. The SVR patients showed lower VR and HR compared to ETR and RNA(+) patients.

Original languageEnglish
Pages (from-to)1449-1455
Number of pages7
JournalTransplantation Proceedings
Volume40
Issue number5
DOIs
StatePublished - Jun 1 2008

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Hepacivirus
RNA
Recurrence
Transplants
Survival
Therapeutics
Liver Transplantation
Interferons

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Effect of Pretransplant Hepatitis C Virus RNA Status on Posttransplant Outcome. / Nudo, C. G.; Cortes, R. A.; Weppler, D.; Schiff, Eugene R; Tzakis, A. G.; Regev, A.

In: Transplantation Proceedings, Vol. 40, No. 5, 01.06.2008, p. 1449-1455.

Research output: Contribution to journalArticle

Nudo, C. G. ; Cortes, R. A. ; Weppler, D. ; Schiff, Eugene R ; Tzakis, A. G. ; Regev, A. / Effect of Pretransplant Hepatitis C Virus RNA Status on Posttransplant Outcome. In: Transplantation Proceedings. 2008 ; Vol. 40, No. 5. pp. 1449-1455.
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abstract = "Undetectable hepatitis C virus (HCV) RNA [RNA(-)] before liver transplantation (OLT) has been shown to decrease the rates of disease recurrence. We sought to determine whether RNA(-) subjects differ in post-OLT recurrence (virological/VR, histological/HR), graft failure (GF), or patient survival from RNA(+) patients using a retrospective review. From 1995 to 2004, a total of 49 patients were RNA(-) at OLT as a result of interferon-based therapy: 22 SVR and 27 with end-of-treatment response (ETR) transplanted when RNA(-) within 6 months of ET. Forty-eight RNA(+) patients were analyzed as controls. Virological recurrence (VR) was seen in 55{\%} of RNA(-) subjects with no difference in HR between RNA(-) vs (+) groups, namely 36.7{\%} versus 56.3{\%} (P = .068), respectively. The RNA(+) subjects showed a lower time to HR (5.6 vs 11 months; P = .027). The SVR subjects displayed lower VR (36.4{\%}) and histological recurrence (HR) (13.6{\%}) compared to ETR (VR 70.4{\%}, P = .023; HR 55.6{\%}, P = .003) or RNA(+) (HR 56{\%}, P = .0008). The SVR subjects, who were identified with a sensitive assay (SVR(S), lower limit <600 IU/mL) showed no VR, HR, or GF. The 1- and 5-year survivals were 87.8{\%}/75.6{\%} and 89.6{\%}/77.8{\%} for RNA(-) and (+) groups, respectively (P = .77). In conclusion, RNA(-)-transplanted patients displayed lower VR and longer time to HR. The SVR patients showed lower VR and HR compared to ETR and RNA(+) patients.",
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