Outcome comparison of liver transplantation for hepatitis A‐related versus hepatitis B‐related acute liver failure in adult recipients |
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| Authors: | Dong‐Hwan Jung Shin Hwang Young‐Suk Lim Ki‐Hun Kim Chul‐Soo Ahn Deok‐Bog Moon Tae‐Yong Ha Gi‐Won Song Gil‐Chun Park Sung‐Gyu Lee |
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| Institution: | 1. Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;2. Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea |
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| Abstract: | Hepatitis A virus (HAV) can cause acute liver failure (ALF). This study compares outcomes between liver transplantation (LT) for HAV‐related ALF (HAV‐ALF) and LT for hepatitis B virus (HBV)‐related ALF (HBV‐ALF). Of 3616 adult LTs performed between January 2005 and December 2014, we performed LT for HAV‐ALF recipients (n = 29) and LT for HBV‐ALF recipients (n = 34). HAV‐ALF group included 18 males and 11 females with mean age of 33.1 years. Graft survival rates in HAV‐ALF and HBV‐ALF were 65.5% and 88.0% (1 year) and 65.5% and 84.0% (5 years) (P = .048). Patient survival rates in HAV‐ALF and HBV‐ALF were 69.0% and 88.0% (1 year) and 69.0% and 84.0% (5 years) (P = .09). Multivariate analyses demonstrated that acute pancreatitis and HAV recurrence were independent risk factors of graft and patient survival. Post‐transplant outcome was poorer in patients with HAV‐ALF than in those with HBV‐ALF. This weakens LT's appropriateness in HAV‐ALF patients with pancreatitis. HAV recurrence after LT for HAV‐ALF is common and often fatal; thus, HAV recurrence should be monitored vigilantly, beginning early post‐transplant. |
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| Keywords: | acute liver failure hepatitis A hepatitis B liver transplantation |
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