1Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA.
2Division of Gastroenterology and Hepatology, Alameda Health System - Highland Hospital Campus, Oakland, CA.
3Division of Nephrology, Stanford University School of Medicine, Stanford, CA.
4Department of Surgery, Stanford University School of Medicine, Stanford, CA.
5Departments of Medicine and Surgery, UCLA, Los Angeles, CA.
6Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA.
7Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA.
The frequency of simultaneous liver kidney transplantation (SLKT) has been increasing over the past decade. Hepatitis C virus (HCV) infection is the most common indication for liver transplantation in the United States. Given the rising prevalence of HCV-related SLKT, it is important to understand the impact of HCV in this patient population.
We conducted a retrospective cohort study using data from the United Network for Organ Sharing registry to assess adult patients undergoing SLKT in the U.S. from 2003 to 2012. Patent survival following SLKT was assessed using Kaplan Meier methods and multivariate Cox proportional hazards models.
Patients infected with HCV have significantly lower survival following SLKT compared to non-HCV patients at 3 (3-year survival: 71.0% vs. 78.9%, p<0.01) and 5 years (5-year survival: 61.4% vs. 72.5%, p<0.01). The results of multivariate regression analyses demonstrated that patients with HCV had significantly lower survival following SLKT than patients with non-HCV disease (HR 1.41, 95% CI, 1.19 - 1.67, p<0.001). In addition, lower post-SLKT survival was noted among patients with diabetes (HR 1.34, 95% CI, 1.13 - 1.58, p<0.001) and hepatocellular carcinoma (HR 1.60, 95% CI, 1.17 - 2.18, p<0.01).
Hepatitis C infection is associated with lower patient survival following SLKT.