Liver transplantation for chronic hepatitis C virus infection in the United States 2002-2014: An analysis of the UNOS/OPTN registry
Chronic hepatitis C virus (HCV) infection is a leading cause for orthotopic liver transplantation (OLT) in the U.S. We investigated characteristics of HCV-infected patients registered for OLT, and explored factors associated with mortality. Data were obtained from the United Network for Organ Sharin...
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| creator | Dultz, Georg Graubard, Barry I Martin, Paul Welker, Martin-Walter Vermehren, Johannes Zeuzem, Stefan McGlynn, Katherine A Welzel, Tania M |
| description | Chronic hepatitis C virus (HCV) infection is a leading cause for orthotopic liver transplantation (OLT) in the U.S. We investigated characteristics of HCV-infected patients registered for OLT, and explored factors associated with mortality. Data were obtained from the United Network for Organ Sharing and Organ Procurement and Transplantation network (UNOS/OPTN) registry. Analyses included 41,157 HCV-mono-infected patients ≥18 years of age listed for cadaveric OLT between February 2002 and June 2014. Characteristics associated with pre- and post-transplant survival and time trends over the study period were determined by logistic and Cox proportional hazard regression analyses and Poisson regressions. Most patients were white (69.1%) and male (70.8%). At waitlist registration, mean age was 54.6 years and mean MELD was 16. HCC was recorded in 26.9% of the records. A total of 51.2% of the patients received an OLT, 21.0% died or were too sick; 15.6% were delisted and 10.4% were still waiting. Factors associated with increased waitlist mortality were older age, female gender, blood type 0, diabetes, no HCC and transplant region (p |
| doi_str_mv | 10.1371/journal.pone.0186898 |
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Data were obtained from the United Network for Organ Sharing and Organ Procurement and Transplantation network (UNOS/OPTN) registry. Analyses included 41,157 HCV-mono-infected patients ≥18 years of age listed for cadaveric OLT between February 2002 and June 2014. Characteristics associated with pre- and post-transplant survival and time trends over the study period were determined by logistic and Cox proportional hazard regression analyses and Poisson regressions. Most patients were white (69.1%) and male (70.8%). At waitlist registration, mean age was 54.6 years and mean MELD was 16. HCC was recorded in 26.9% of the records. A total of 51.2% of the patients received an OLT, 21.0% died or were too sick; 15.6% were delisted and 10.4% were still waiting. Factors associated with increased waitlist mortality were older age, female gender, blood type 0, diabetes, no HCC and transplant region (p<0.001). OLT recipient characteristics associated with increased risk for post OLT mortality were female gender, age, diabetes, race (p<0,0001), and allocation MELD (p = 0.005). Donor characteristics associated with waitlist mortality included age, ethnicity (p<0.0001) and diabetes (p<0.03). Waitlist registrations and OLTs for HCC significantly increased from 14.4% to 37.3% and 27.8% to 38.5%, respectively (p<0.0001). Pre- and post-transplant survival depended on a variety of patient-, donor-, and allocation- characteristics of which most remain relevant in the DAA-era. Still, intensified HCV screening strategies and timely and effective treatment of HCV are highly relevant to reduce the burden of HCV-related OLTs in the U.S.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0186898</identifier><identifier>PMID: 29088255</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Aged ; Baby boomers ; Biology and life sciences ; Blood & organ donations ; Cadavers ; Care and treatment ; Chronic infection ; Diabetes ; Diabetes mellitus ; Epidemiology ; Female ; Gastroenterology ; Health aspects ; Hepatitis ; Hepatitis C ; Hepatitis C, Chronic - mortality ; Hepatitis C, Chronic - surgery ; Hepatology ; Hospitals ; Humans ; Infections ; Liver ; Liver cancer ; Liver cirrhosis ; Liver diseases ; Liver transplantation ; Liver Transplantation - methods ; Liver Transplantation - mortality ; Liver transplants ; Logistic Models ; Male ; Medicine and Health Sciences ; Middle Aged ; Minority & ethnic groups ; Mortality ; Outcome Assessment, Health Care - methods ; Outcome Assessment, Health Care - statistics & numerical data ; Patients ; People and Places ; Population ; Proportional Hazards Models ; Registries - statistics & numerical data ; Regression analysis ; Risk factors ; Survival ; Survival Analysis ; Survival Rate ; Tissue and Organ Procurement - methods ; Transplantation ; Transplants & implants ; Trends ; United States ; Viruses ; Waiting Lists</subject><ispartof>PloS one, 2017-10, Vol.12 (10), p.e0186898-e0186898</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication: https://creativecommons.org/publicdomain/zero/1.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-263fa32e6ee5a49cdc63deadb285837ab3f6f72c50d02c92eaf719fa79eea193</citedby><cites>FETCH-LOGICAL-c692t-263fa32e6ee5a49cdc63deadb285837ab3f6f72c50d02c92eaf719fa79eea193</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5663425/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5663425/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29088255$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Gruttadauria, Salvatore</contributor><creatorcontrib>Dultz, Georg</creatorcontrib><creatorcontrib>Graubard, Barry I</creatorcontrib><creatorcontrib>Martin, Paul</creatorcontrib><creatorcontrib>Welker, Martin-Walter</creatorcontrib><creatorcontrib>Vermehren, Johannes</creatorcontrib><creatorcontrib>Zeuzem, Stefan</creatorcontrib><creatorcontrib>McGlynn, Katherine A</creatorcontrib><creatorcontrib>Welzel, Tania M</creatorcontrib><title>Liver transplantation for chronic hepatitis C virus infection in the United States 2002-2014: An analysis of the UNOS/OPTN registry</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Chronic hepatitis C virus (HCV) infection is a leading cause for orthotopic liver transplantation (OLT) in the U.S. We investigated characteristics of HCV-infected patients registered for OLT, and explored factors associated with mortality. Data were obtained from the United Network for Organ Sharing and Organ Procurement and Transplantation network (UNOS/OPTN) registry. Analyses included 41,157 HCV-mono-infected patients ≥18 years of age listed for cadaveric OLT between February 2002 and June 2014. Characteristics associated with pre- and post-transplant survival and time trends over the study period were determined by logistic and Cox proportional hazard regression analyses and Poisson regressions. Most patients were white (69.1%) and male (70.8%). At waitlist registration, mean age was 54.6 years and mean MELD was 16. HCC was recorded in 26.9% of the records. A total of 51.2% of the patients received an OLT, 21.0% died or were too sick; 15.6% were delisted and 10.4% were still waiting. Factors associated with increased waitlist mortality were older age, female gender, blood type 0, diabetes, no HCC and transplant region (p<0.001). OLT recipient characteristics associated with increased risk for post OLT mortality were female gender, age, diabetes, race (p<0,0001), and allocation MELD (p = 0.005). Donor characteristics associated with waitlist mortality included age, ethnicity (p<0.0001) and diabetes (p<0.03). Waitlist registrations and OLTs for HCC significantly increased from 14.4% to 37.3% and 27.8% to 38.5%, respectively (p<0.0001). Pre- and post-transplant survival depended on a variety of patient-, donor-, and allocation- characteristics of which most remain relevant in the DAA-era. Still, intensified HCV screening strategies and timely and effective treatment of HCV are highly relevant to reduce the burden of HCV-related OLTs in the U.S.</description><subject>Age</subject><subject>Aged</subject><subject>Baby boomers</subject><subject>Biology and life sciences</subject><subject>Blood & organ donations</subject><subject>Cadavers</subject><subject>Care and treatment</subject><subject>Chronic infection</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Health aspects</subject><subject>Hepatitis</subject><subject>Hepatitis C</subject><subject>Hepatitis C, Chronic - mortality</subject><subject>Hepatitis C, Chronic - surgery</subject><subject>Hepatology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infections</subject><subject>Liver</subject><subject>Liver cancer</subject><subject>Liver cirrhosis</subject><subject>Liver diseases</subject><subject>Liver transplantation</subject><subject>Liver Transplantation - methods</subject><subject>Liver Transplantation - mortality</subject><subject>Liver transplants</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Minority & ethnic groups</subject><subject>Mortality</subject><subject>Outcome Assessment, Health Care - methods</subject><subject>Outcome Assessment, Health Care - statistics & numerical data</subject><subject>Patients</subject><subject>People and Places</subject><subject>Population</subject><subject>Proportional Hazards Models</subject><subject>Registries - statistics & numerical data</subject><subject>Regression analysis</subject><subject>Risk factors</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>Survival Rate</subject><subject>Tissue and Organ Procurement - methods</subject><subject>Transplantation</subject><subject>Transplants & implants</subject><subject>Trends</subject><subject>United States</subject><subject>Viruses</subject><subject>Waiting 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the UNOS/OPTN registry</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2017-10-31</date><risdate>2017</risdate><volume>12</volume><issue>10</issue><spage>e0186898</spage><epage>e0186898</epage><pages>e0186898-e0186898</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Chronic hepatitis C virus (HCV) infection is a leading cause for orthotopic liver transplantation (OLT) in the U.S. We investigated characteristics of HCV-infected patients registered for OLT, and explored factors associated with mortality. Data were obtained from the United Network for Organ Sharing and Organ Procurement and Transplantation network (UNOS/OPTN) registry. Analyses included 41,157 HCV-mono-infected patients ≥18 years of age listed for cadaveric OLT between February 2002 and June 2014. Characteristics associated with pre- and post-transplant survival and time trends over the study period were determined by logistic and Cox proportional hazard regression analyses and Poisson regressions. Most patients were white (69.1%) and male (70.8%). At waitlist registration, mean age was 54.6 years and mean MELD was 16. HCC was recorded in 26.9% of the records. A total of 51.2% of the patients received an OLT, 21.0% died or were too sick; 15.6% were delisted and 10.4% were still waiting. Factors associated with increased waitlist mortality were older age, female gender, blood type 0, diabetes, no HCC and transplant region (p<0.001). OLT recipient characteristics associated with increased risk for post OLT mortality were female gender, age, diabetes, race (p<0,0001), and allocation MELD (p = 0.005). Donor characteristics associated with waitlist mortality included age, ethnicity (p<0.0001) and diabetes (p<0.03). Waitlist registrations and OLTs for HCC significantly increased from 14.4% to 37.3% and 27.8% to 38.5%, respectively (p<0.0001). Pre- and post-transplant survival depended on a variety of patient-, donor-, and allocation- characteristics of which most remain relevant in the DAA-era. Still, intensified HCV screening strategies and timely and effective treatment of HCV are highly relevant to reduce the burden of HCV-related OLTs in the U.S.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29088255</pmid><doi>10.1371/journal.pone.0186898</doi><tpages>e0186898</tpages><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_1958246156 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Age Aged Baby boomers Biology and life sciences Blood & organ donations Cadavers Care and treatment Chronic infection Diabetes Diabetes mellitus Epidemiology Female Gastroenterology Health aspects Hepatitis Hepatitis C Hepatitis C, Chronic - mortality Hepatitis C, Chronic - surgery Hepatology Hospitals Humans Infections Liver Liver cancer Liver cirrhosis Liver diseases Liver transplantation Liver Transplantation - methods Liver Transplantation - mortality Liver transplants Logistic Models Male Medicine and Health Sciences Middle Aged Minority & ethnic groups Mortality Outcome Assessment, Health Care - methods Outcome Assessment, Health Care - statistics & numerical data Patients People and Places Population Proportional Hazards Models Registries - statistics & numerical data Regression analysis Risk factors Survival Survival Analysis Survival Rate Tissue and Organ Procurement - methods Transplantation Transplants & implants Trends United States Viruses Waiting Lists |
| title | Liver transplantation for chronic hepatitis C virus infection in the United States 2002-2014: An analysis of the UNOS/OPTN registry |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T14%3A42%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Liver%20transplantation%20for%20chronic%20hepatitis%20C%20virus%20infection%20in%20the%20United%20States%202002-2014:%20An%20analysis%20of%20the%20UNOS/OPTN%20registry&rft.jtitle=PloS%20one&rft.au=Dultz,%20Georg&rft.date=2017-10-31&rft.volume=12&rft.issue=10&rft.spage=e0186898&rft.epage=e0186898&rft.pages=e0186898-e0186898&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0186898&rft_dat=%3Cgale_plos_%3EA512496578%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1958246156&rft_id=info:pmid/29088255&rft_galeid=A512496578&rft_doaj_id=oai_doaj_org_article_1fc4acfae6e0472fad7bb18aedde107c&rfr_iscdi=true |