Survival after transplant for HCV decreased at long-term follow-up

BOSTON — Data from a single-center study of patients who underwent liver transplantation for hepatitis C virus demonstrate a decreased rate of survival between 10 and 20 years.

The study included 789 patients with HCV who underwent transplantation at the University of Pittsburgh from 1993 to 2013.

The overall survival rate was 52% at 10 years, 42.4% at 15 years and 32.9% at 20 years.

Few studies have reported follow-up data beyond 10 years for patients with HCV in the transplant setting, according to the researchers. The goal was to “report a single-center experience with 20-year follow-up,” Vikrant Rachakonda, MD, a transplant hepatology fellow at University of Pittsburgh, told HCV Next at The Liver Meeting.

The average age of the patients was 52.3 years, more than half were men, 93% were white and most were overweight. “This is a reflection of our population in Pittsburgh,” Rachakonda said.

The researchers also stratified the patient population according to HCV genotype, MELD score, sex and age. HCV genotype information was available for 421 patients. Of those, 80.5% had genotype 1 infection, 7.6% genotype 2.9% genotype 3 and 2.9% genotype 4. At the time of transplant, the patients’ mean MELD score was 20.

Men had a significantly higher rate of survival than women between 15 and 20 years. Rachakonda noted that the survival difference was most pronounced at the 5- to 10-year follow-up. “We still have to follow-up to determine whether this is a signal for another causative factor,” he said.

Genotype, age older or younger than the median of 52 years and MELD score above or below the median also had no impact on outcomes, Rachakonda said. He added that these factors did not impact allograft survival, but that men tended to have slightly better allograft survival outcomes than women.

The researchers concluded that all-cause mortality after transplantation may vary between men and women, and deserves further study. – by Rob Volansky

For more information:

Rustgi VK. Poster 565. Presented at: The Liver Meeting; Nov. 7-11, 2014; Boston.

Disclosure: The researchers report associations with AbbVie, Achillion, Bristol-Myers Squibb and Gilead.