HBV obtained during childhood may lead to early death post-transplant

Young adults who underwent liver transplant for hepatitis B virus infection obtained in early childhood had a decreased overall survival rate in adulthood, according to data presented at the 2015 North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Annual Meeting.

Researchers from Cleveland Clinic, Ohio, including Ibrahim Hanouneh, MD, and Naim Alkhouri, MD, examined data from the United Network for Organ Sharing (UNOS) database of 522 young adults aged between 18 and 35 years old who underwent liver transplant (LT) after diagnosis of HBV or were seropositive for hepatitis B surface antigen (HBsAg) at time of transplant.

Ibrahim Hanouneh

“The aim of this study was to assess the characteristics of HBV-positive young adults who received LT, and to evaluate post-transplant outcomes including patients and graft survival and the need for retransplantation,” the researchers wrote.

Among all the recipients, the average age at the time of LT was 28.4 ± 5.2 years. All patients underwent initial transplant, with 74 undergoing a second LT and 12 undergoing a third LT. During a median follow-up of 48.2 months after first LT, 33.3% of patients died (n = 174) and the mean age of death was 31.6 ± 7.8 years. Of these patients, 28% had died after first LT (n = 144), 35% died after the second LT (n = 26) and 33% died after a third LT (n = 4). The most common causes of mortality were graft failure (27.6%) and infection (16.6%).

Overall, 58% of patients who were alive at their first transplant were still alive at the last follow-up date. Patient and graft survival rates after retransplantation were found to be lower compared with initial LT, according to a Kaplan-Meier analysis.

“LT in young adults for HBV acquired during childhood had poor outcomes and can be associated with premature death,” the researchers concluded. “These findings should prompt more aggressive evaluation and treatment for HBV in children.”

Reference:

Anani A, et al. Abstract 160. Presented at: 2015 NASPGHAN Annual Meeting; Oct. 7-11; Washington, D.C.

Disclosures: Healio.com/Hepatology was unable to confirm relevant financial disclosures at the time of publication.