Ann Surg Treat Res.  2016 Jan;90(1):36-42. 10.4174/astr.2016.90.1.36.

Outcomes for patients with HCV after liver transplantation in Korea: a multicenter study

• Kim JM
• Lee KW
• Song GW
• Jung BH
• Lee HW
• Yi NJ
• Kwon CH
• Hwang S
• Suh KS
• Joh JW
• Lee SK
• Lee SG

• KMID: 2149930
• DOI: http://doi.org/10.4174/astr.2016.90.1.36

Abstract

PURPOSE
HCV-related liver disease is the most common indication for liver transplantation (LT) in Western countries, whereas HCV LT is rare in Korea. We conducted a survey of HCV RNA-positive patients who underwent LT and investigated the prognostic factors for patient survival and the effects of immunosuppression.
METHODS
We retrospectively reviewed the multicenter records of 192 HCV RNA-positive patients who underwent LT.
RESULTS
The 1-, 3-, and 5-year overall survival rates were 78.8%, 75.3%, and 73.1%, respectively. Excluding the cases of hospital mortality (n = 23), 169 patients were evaluated for patient survival. Most patients were genotype 1 (n = 111, 65.7%) or genotype 2 (n = 42, 24.9%). The proportion of living donors for LT (n = 135, 79.9%) was higher than that of deceased donors (deceased donor liver transplantation [DDLT], n = 34, 20.1%). The median donor and recipient ages were 32 years and 56 years, respectively. Twenty-eight patients (16.6%) died during the observation period. Seventy-five patients underwent universal prophylaxis and 15 received preemptive therapy. HCV recurrence was detected in 97 patients. Recipients who were older than 60, received DDLT, used cyclosporine, or suffered acute rejection had lower rates of survival.
CONCLUSION
Patent survival rates of HCV patients after LT in Korea were comparable with other countries.

Keyword

Hepatitis C virus; Tacrolimus; Acute rejection; Survival; Antiviral treatments

MeSH Terms

Cyclosporine
Genotype
Hepacivirus
Hospital Mortality
Humans
Immunosuppression
Korea*
Liver Diseases
Liver Transplantation*
Liver*
Living Donors
Recurrence
Retrospective Studies
Survival Rate
Tacrolimus
Tissue Donors
Cyclosporine
Tacrolimus

Figure

• 

  Fig. 1 Patient survival rates. The 1-, 3-, and 5-year patient survival rates are 78.8%, 75.3%, and 73.1%, respectively.

• 

  Fig. 2 Patient survival according to recipient age (A), donor type (B), calcineurin inhibitor (C), and BPAR (D). LDLT, living donor liver transplantation; DDLT, deceased donor liver transplantation; Tac, Tacrolimus; CsA, cyclosporin; BPAR, biopsy-proven acute rejection.

• 

  Fig. 3 Patient survival according to sustained viral response (SVR). Patient survival in patients with SVR was higher than in patients without SVR, but there was no statistically significant difference in patient survival between the two groups.

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