Equivalent outcomes with retransplantation and primary liver transplantation in the direct-acting antiviral era

Kristopher Croome, Amit K. Mathur, Surakit Pungpapong, David D. Lee, Adyr Moss, Charles Rosen, Julie Heimbach, C. Burcin Taner

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background. The present multicenter study investigated whether equivalent outcomes to primary liver transplant (LT) could be achieved with liver retransplant (reLT) and whether improvements in outcomes have taken place over time, particularly in the direct-acting antiviral era. Methods. All reLT performed at Mayo Clinic Florida, Mayo Clinic Rochester, and Mayo Clinic Arizona were divided into era 1 (2002-2007), era 2 (2008-2012), and era 3 (2013-2017) based on the date of reLT. Results. Improvement in graft survival (GS) after reLT was seen over the 3 eras (P < 0.001). In era 1, GS after reLT was inferior to primary LT (P < 0.001), whereas no difference was seen between reLT and primary LT in era 2 (P = 0.68) or era 3 (P = 0.36). A significantly higher proportion of patients achieved sustained viral response (SVR) within the first year after reLT in each subsequent era (era 1: 10.3%, era 2: 22.5%, and era 3: 100%) (P < 0.001). Graft survival was superior in patients undergoing reLT for recurrent hepatitis C virus who achieved SVR after reLT compared with those who did not (P = 0.03). Conclusions. Results similar to primary LT were achieved in era 3. These improvements coincide with the availability of direct-acting antivirals, which resulted in a 100% SVR rate in era 3 and a decrease in the number of patients undergoing reLT for recurrent hepatitis C virus. The historic dogma that reLT results in inferior outcomes should be revisited.

Original languageEnglish (US)
Pages (from-to)1168-1174
Number of pages7
JournalTransplantation
Volume103
Issue number6
DOIs
StatePublished - Jun 1 2019

ASJC Scopus subject areas

  • Transplantation

Fingerprint Dive into the research topics of 'Equivalent outcomes with retransplantation and primary liver transplantation in the direct-acting antiviral era'. Together they form a unique fingerprint.

Cite this