Predictors of patient and graft survival following liver transplantation for hepatitis C

End‐stage liver disease secondary to hepatitis C virus (HCV) infection is the leading indication for liver transplantation in the United States. Recurrence of HCV infection is nearly universal. We studied the patients enrolled in the National Institute of Diabetes and Digestive and Kidney Diseases Liver Transplantation Database to determine whether pretransplantation patient or donor variables could identify a subset of HCV‐infected recipients with poor patient survival. Between April 15, 1990, and June 30, 1994, 166 HCV‐infected and 509 HCV‐negative patients underwent liver transplantation at the participating institutions. Median follow‐up was 5.0 years for HCV‐infected and 5.2 years for HCV‐negative recipients. Pretransplantation donor and recipient characteristics, and patient and graft survival, were prospectively collected and compared. Cumulative patient survival for HCV‐infected recipients was similar to that of recipients transplanted for chronic non–B‐C hepatitis, or alcoholic and metabolic liver disease, better than that of patients transplanted for malignancy or hepatitis B (P= .02 and P= .003, respectively), and significantly worse than that of patients transplanted for cholestatic liver disease (P= .001). Recipients who had a pretransplantation HCV‐RNA titer of ≥1 × 106 vEq/mL had a cumulative 5‐year survival of 57% versus 84% for those with HCV‐RNA titers of