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HCV-related HCC lowers survival after liver transplant

Patients with hepatitis C virus infection-related hepatocellular carcinoma who underwent liver transplantation were at an increased risk for developing negative outcomes, such as graft loss and reduced survival, compared with patients with HCC due to other causes, according to published findings.

Zobair M. Younossi, MD, MPH, chairman of the department of medicine, Inova Fairfax Hospital, and vice president for research of Inova Health System, and colleagues evaluated the impact of etiology of liver disease on patient and graft survival after liver transplantation for HCC among 8,733 liver transplant (LT) recipients. Of the recipients enrolled in the Scientific Registry of Transplant Recipients from 2002 to 2011, 5,507 were diagnosed with HCV, 631 had HBV, 163 had HBV/HCV coinfection, and 2,432 had nonviral causes of liver disease.

Zobair M. Younossi

During follow-up (48 ± 32 months), 8.2% had graft failure (n = 717). The mean rate of graft failure was 9.5% in patients with HCV, 4.7% in HBV, 6.1% in coinfection and 6.4% in nonviral liver disease (P < .0001).

Also over the course of follow-up, 29.5% died (n = 2,470). The mortality rate after LT was 20.2% in patients with HBV, 31% in those with HCV, 28.5% in coinfection and 28.5% in nonviral liver diseases (P < .0001).

“This difference was significant starting 1 year posttransplant and became even more prominent later in follow-up,” Younossi and colleagues wrote.

The 5-year posttransplant survival rates were 64.7% in patients with HCV, 77.7% in HBV, 71% in coinfection and 69.1% in nonviral HCC (P < .0001).

Multivariate analysis showed a diagnosis of HCV in patients with HCC was independently associated with an increased risk for graft failure (adjusted HR = 1.84; 95% CI, 1.46-2.32) and mortality (aHR = 1.35; 95% CI, 1.21-1.49).

“HCV-HCC patients demonstrated an increased graft loss and lower survival when compared to patients who have HCC because of any other cause,” the researchers concluded. “It is only with highly effective anti-HCV regimens prior to transplant and posttransplant that the prognosis of these patients can potentially improve.” – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.