Hepatitis C recurrence post-tranplantation is common although the degree of histologic recurrence is variable. The cumulative probability of progressing to graft cirrhosis is 30% at 5 years. Predictors of recurrence may include older donor age, immunosuppressive regimen, bolus steroid use, allograft steatosis, viral load and genotype. The donor risk index (DRI), comprising 8 donor risk factors, was recently described as a potential objective tool to guide organ acceptance. This index was derived from donor characteristics that predicted graft failure. The goal of this study was to determine whether DRI and MELD score at time of transplantation have an effect on early hepatitis C recurrence post transplantation. Retrospective review of patients transplanted for hepatitis C at London Health Sciences Centre in London, Ontario between 1999-2004. Early recurrence was defined as presence of fibrosis ≥stage 2) on liver biopsy at 2 years or less. Donor characteristic were collected to calculate the DRI as published by Feng et al. Uncorrected MELD score was calculated based on day of transplantation. Results 31 recipients (Group A) with liver biopsy evidence of early recurrence were compared to 28 recipients that had no histology evidence of HCV recurrence (Group B). The mean DRI was statistically higher in Group A (1.66±0.407) than Group B (1.39 ± 0.294) (p-value of 0.0053). Mean donor age was 49 in Group A and 33 in Group B (p = 0.0002). Average uncorrected MELD score was not statistically different (16.6 ± 6.02 vs. 17.1±5.8 p = NS). In Conclusion, DRI and age are predictive of early histological hepatitis C recurrence post transplantation. Uncorrected MELD score at time of transplantation has no influence on early HCV recurrence.
Volume : 6
Issue : 4
Pages : 5
Multi Organ Transplant Program, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada