Outcome of Combined Liver and Kidney Transplantation in Hepatitis C: A Single-Center Long-Term Follow-up Experience |
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Authors: | A.C. del Pozo,J.d.R. Martí n,M. Sturdevant,K. Iyer,T. Schiano,S. Lerner,J. Bromberg,G. de Boccardo |
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Affiliation: | a Recanti/Miller Transplant Institute, Mount Sinai Medical Center, New York, USA b Department of Surgical Oncology, Mount Sinai Medical Center, New York, USA c Division of Liver Diseases, Mount Sinai Medical Center, New York, USA d Department of Pathology, Mount Sinai Medical Center, New York, New York, USA |
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Abstract: |
IntroductionHepatitis C (HCV) cirrhosis is the prevalent liver disease requiring liver transplantation in the United States. Candidates who also have end-stage renal disease, chronic renal disease stage 4, or prolonged hepatorenal syndrome are considered for combined liver and kidney transplantation (CLKT).Materials and methodsWe performed a retrospective study of HCV(+) and HCV(−) CLKT patients with more than 12 months of follow-up and HCV(+) patients with isolated liver transplant (OLT) to compare the outcomes of various groups.ResultsSince 1988, 2983 OLTs were performed at our institution including 58 CLKTs. Of these, 23 were HCV(+) subjects who were significantly older than HCV(−) CLKT patients. Race, pretransplant dialysis time, renal indication for CLKT, Model for End-stage Liver Disease score, donor age, liver and kidney rejection as well as occurrence of posttransplant hypertension were similar among HCV(+) and HCV(−) CLKT patients. Posttransplant diabetes was observed in 80% of the HCV(+) group and 30% of the HCV(−) group (P = .01). Renal function seemed to be better in HCV(−) when compared with HCV(+) subjects at 5 years (P = .09). Overall patient survival for HCV(+) CLKT, HCV(−) CLKT, and HCV(+) OLT groups at 1, 2, and 5 years were not significantly different (P = .6).ConclusionHCV positivity should not exclude appropriate candidates for CLKT. |
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