𝔖 Bobbio Scriptorium
✦   LIBER   ✦

Survival after liver transplantation for hepatocellular carcinoma in the model for end-stage liver disease and pre–model for end-stage liver disease eras and the independent impact of hepatitis C virus

✍ Scribed by Paul J. Thuluvath; Anurag Maheshwari; Nimisha P. Thuluvath; Geoffrey C. Nguyen; Dorry L. Segev

Publisher
John Wiley and Sons
Year
2009
Tongue
English
Weight
248 KB
Volume
15
Category
Article
ISSN
1527-6465

No coin nor oath required. For personal study only.

✦ Synopsis

It has been suggested that hepatitis C virus (HCV) patients with hepatocellular carcinoma (HCC) may have worse outcomes after liver transplantation (LT) because of more aggressive tumor biology. In this study, we determined the post-LT survival of HCC patients with and without HCV using United Network for Organ Sharing data from January 1994 to March 2008. Patients with HCC were stratified into HCV (HCC-HCV) and non-HCV (HCC-non-HCV) groups. In the era before the Model for End-Stage Liver Disease (MELD), there were 1237 HCC patients (780, HCV; 373, non-HCV; 84, unknown HCV status), and during the MELD era, there were 4933 HCC patients (3272, HCV; 1348, non-HCV; 313, unknown). In the pre-MELD era, 5-year graft (58.6% versus 53.7%) and patient (61.7% versus 59.3%) survival rates were marginally higher for HCC-non-HCV patients than for HCC-HCV patients. In the MELD era also, 5-year graft (61.2% versus 55.5%) and patient (63.7% versus 58.2%) survival rates were marginally higher for HCC-non-HCV patients than for HCC-HCV patients. In patients without HCC, pre-MELD and MELD era graft/patient survival rates for non-HCV patients were higher than those for HCV patients. The differences in survival rates for HCC patients with and without HCV were lower than those for non-HCC patients stratified by their HCV status. HCV had no additional negative impact on the post-LT survival of patients with HCC, and this was further confirmed by multivariate analysis. In conclusion, the survival of HCC patients has remained unchanged in the past 2 decades. HCV patients have a lower survival rate than non-HCV patients, regardless of their HCC status, but HCV has no additional negative impact on survival in patients with HCC.

📜 SIMILAR VOLUMES

Renal outcomes after liver transplantati
Renal outcomes after liver transplantation in the model for end-stage liver disease era
✍ Pratima Sharma; Kathy Welch; Richard Eikstadt; Jorge A. Marrero; Robert J. Fonta 📂 Article 📅 2009 🏛 John Wiley and Sons 🌐 English ⚖ 193 KB 👁 2 views

The proportion of patients undergoing liver transplantation (LT) with renal insufficiency has significantly increased in the Model for End-Stage Liver Disease (MELD) era. This study was designed to determine the incidence and predictors of post-LT chronic renal failure (CRF) and its effect on patien

Clinically relevant differences in the M
Clinically relevant differences in the Model for End-Stage Liver Disease and Model for End-Stage Liver Disease–sodium scores
✍ Rhiana Garritsen; Andrei Tintu; Herold Metselaar; Geert Kazemier 📂 Article 📅 2009 🏛 John Wiley and Sons 🌐 English ⚖ 38 KB 👁 1 views

With interest, we read the article by Xiol et al. 1 regarding differences in serum measurements between different laboratories and their influence on the Model for End-Stage Liver Disease (MELD) and the Model for End-Stage Liver Disease incorporating serum sodium (MELD-Na). They reported significant

Reply: Clinically relevant differences i
Reply: Clinically relevant differences in the model for end-stage liver disease and model for end-stage liver disease–sodium scores
✍ Xavier Xiol; Jose Castellote; Xavier Fuentes-Arderiu 📂 Article 📅 2009 🏛 John Wiley and Sons 🌐 English ⚖ 37 KB 👁 1 views

We thank Garritsen et al. 1 for their interest in our article about differences in Model for End-Stage Liver Disease (MELD) and Model for End-Stage Liver Disease-Sodium (MELD-Na) scores determined at 3 different laboratories. 2 We agree that one of the important messages of our article is the import

Liver transplantation cost in the model
Liver transplantation cost in the model for end-stage liver disease era: Looking beyond the transplant admission
✍ Paula Buchanan; Nino Dzebisashvili; Krista L. Lentine; David A. Axelrod; Mark A. 📂 Article 📅 2009 🏛 John Wiley and Sons 🌐 English ⚖ 120 KB 👁 1 views

We examined the relationship between the total cost incurred by liver transplantation (LT) recipients and their Model for End-Stage Liver Disease (MELD) score at the time of transplant. We used a novel database linking billing claims from a large private payer with the Organ Procurement and Transpla

Model for end-stage liver disease except
Model for end-stage liver disease exceptions in the context of the french model for end-stage liver disease score–based liver allocation system
✍ Claire Francoz; Jacques Belghiti; Denis Castaing; Olivier Chazouillères; Jean-Ch 📂 Article 📅 2011 🏛 John Wiley and Sons 🌐 English ⚖ 437 KB 👁 1 views

Model for End-Stage Liver Disease (MELD) score-based allocation systems have been adopted by most countries in Europe and North America. Indeed, the MELD score is a robust marker of early mortality for patients with cirrhosis. Except for extreme values, high pretransplant MELD scores do not signific

Posttransplant biliary complications in
Posttransplant biliary complications in the pre- and post-model for end-stage liver disease era
✍ Vinay Sundaram; Deborah T. Jones; Nilesh H. Shah; Michael E. de Vera; Paulo Font 📂 Article 📅 2011 🏛 John Wiley and Sons 🌐 English ⚖ 148 KB 👁 1 views

Biliary complications remain a cause of morbidity after liver transplantation. The aim of this study was to determine whether changes in clinical practice in the era of the Model for End-Stage Liver Disease (MELD) has affected biliary complications after liver transplantation. We retrospectively rev