Liver transplantation for cryptogenic cirrhosis

M. R. Charlton, M. Kondo, S. K. Roberts, J. L. Steers, R. A F Krom, R. H. Wiesner

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

End-stage liver disease secondary to cryptogenic cirrhosis is the indication for orthotopic liver transplantation (OLT) in 7% to 14% of recipients. However, there are no reports documenting the outcome of OLT for this indication. The aim of this study was to determine (1) survival and (2) the incidence of histological recurrence of cryptogenic cirrhosis after OLT. Between March 1985 and December 1994, 660 OLTs were performed at our institution. Of these, 39 transplants for cryptogenic cirrhosis were in patients who met the following criteria: antinuclear antibody <1:40; negative anti-smooth muscle antibody, antimitochondrial antibody, polymerase chain reaction for hepatitis C virus, and hepatitis B surface antigen results; normal ceruloplasmin and α-1 antitrypsin phenotype; transferrin saturation < 65%; and liver biopsy specimen not suggestive of hemochromatosis or other known disorders. Histological recurrence was assessed with protocol liver biopsies in all patients who survived longer than 6 months. The mean age of cryptogenic recipients at the time of transplantation was significantly lower (40.6 years; range, 3 to 63 years) than that of noncryptogenic recipients (48.5 years; range, 1-70; P < .03). Median modified Child's-Pugh score was slightly higher for cryptogenic recipients at the time of transplantation (10.0 + 0.08 standard error of mean [SEM]), than for the noncryptogenic recipients (9.0 + 0.03 SEM; P < .02). Actuarial survival was 72% (+ 0.07 SEM) at 1 and 58% (+ 0.08 SEM) at 5 years for cryptogenic recipients compared with 89% at 1 and 80% at 5 years for noncryptogenic recipients. The difference in survival was significant (P < .001) at both 1 and 5 years. Among the 27 cryptogenic recipients surviving more than 6 months (mean follow-up, 5.5 years), 6 have persistent hepatitis histologically without apparent infectious, vascular, biliary, or drug origins. Four patients (15%) had chronic active hepatitis, and 2 (7%) had steatohepatitis. No cases of recurrent cryptogenic cirrhosis were seen. OLT for cryptogenic cirrhosis is associated with a poor outcome compared with other indications, hepatitis of uncertain origin occurred in 22% of cryptogenic recipients surviving longer than 6 months, and no evidence of recurrence of cryptogenic cirrhosis was seen thus far in follow-up.

Original languageEnglish (US)
Pages (from-to)359-364
Number of pages6
JournalLiver Transplantation and Surgery
Volume3
Issue number4
StatePublished - 1997

Fingerprint

Liver Transplantation
Recurrence
Hepatitis
Survival
Transplantation
Biopsy
End Stage Liver Disease
Ceruloplasmin
Hemochromatosis
Antibodies
Liver
Antinuclear Antibodies
Fatty Liver
Chronic Hepatitis
Transferrin
Hepatitis B Surface Antigens
Hepacivirus
Smooth Muscle
Blood Vessels
Cryptogenic Cirrhosis

ASJC Scopus subject areas

  • Hepatology
  • Surgery

Cite this

Charlton, M. R., Kondo, M., Roberts, S. K., Steers, J. L., Krom, R. A. F., & Wiesner, R. H. (1997). Liver transplantation for cryptogenic cirrhosis. Liver Transplantation and Surgery, 3(4), 359-364.

Liver transplantation for cryptogenic cirrhosis. / Charlton, M. R.; Kondo, M.; Roberts, S. K.; Steers, J. L.; Krom, R. A F; Wiesner, R. H.

In: Liver Transplantation and Surgery, Vol. 3, No. 4, 1997, p. 359-364.

Research output: Contribution to journalArticle

Charlton, MR, Kondo, M, Roberts, SK, Steers, JL, Krom, RAF & Wiesner, RH 1997, 'Liver transplantation for cryptogenic cirrhosis', Liver Transplantation and Surgery, vol. 3, no. 4, pp. 359-364.
Charlton MR, Kondo M, Roberts SK, Steers JL, Krom RAF, Wiesner RH. Liver transplantation for cryptogenic cirrhosis. Liver Transplantation and Surgery. 1997;3(4):359-364.
Charlton, M. R. ; Kondo, M. ; Roberts, S. K. ; Steers, J. L. ; Krom, R. A F ; Wiesner, R. H. / Liver transplantation for cryptogenic cirrhosis. In: Liver Transplantation and Surgery. 1997 ; Vol. 3, No. 4. pp. 359-364.
@article{fe4531ccaa0f4665b5be6e475e6abe03,
title = "Liver transplantation for cryptogenic cirrhosis",
abstract = "End-stage liver disease secondary to cryptogenic cirrhosis is the indication for orthotopic liver transplantation (OLT) in 7{\%} to 14{\%} of recipients. However, there are no reports documenting the outcome of OLT for this indication. The aim of this study was to determine (1) survival and (2) the incidence of histological recurrence of cryptogenic cirrhosis after OLT. Between March 1985 and December 1994, 660 OLTs were performed at our institution. Of these, 39 transplants for cryptogenic cirrhosis were in patients who met the following criteria: antinuclear antibody <1:40; negative anti-smooth muscle antibody, antimitochondrial antibody, polymerase chain reaction for hepatitis C virus, and hepatitis B surface antigen results; normal ceruloplasmin and α-1 antitrypsin phenotype; transferrin saturation < 65{\%}; and liver biopsy specimen not suggestive of hemochromatosis or other known disorders. Histological recurrence was assessed with protocol liver biopsies in all patients who survived longer than 6 months. The mean age of cryptogenic recipients at the time of transplantation was significantly lower (40.6 years; range, 3 to 63 years) than that of noncryptogenic recipients (48.5 years; range, 1-70; P < .03). Median modified Child's-Pugh score was slightly higher for cryptogenic recipients at the time of transplantation (10.0 + 0.08 standard error of mean [SEM]), than for the noncryptogenic recipients (9.0 + 0.03 SEM; P < .02). Actuarial survival was 72{\%} (+ 0.07 SEM) at 1 and 58{\%} (+ 0.08 SEM) at 5 years for cryptogenic recipients compared with 89{\%} at 1 and 80{\%} at 5 years for noncryptogenic recipients. The difference in survival was significant (P < .001) at both 1 and 5 years. Among the 27 cryptogenic recipients surviving more than 6 months (mean follow-up, 5.5 years), 6 have persistent hepatitis histologically without apparent infectious, vascular, biliary, or drug origins. Four patients (15{\%}) had chronic active hepatitis, and 2 (7{\%}) had steatohepatitis. No cases of recurrent cryptogenic cirrhosis were seen. OLT for cryptogenic cirrhosis is associated with a poor outcome compared with other indications, hepatitis of uncertain origin occurred in 22{\%} of cryptogenic recipients surviving longer than 6 months, and no evidence of recurrence of cryptogenic cirrhosis was seen thus far in follow-up.",
author = "Charlton, {M. R.} and M. Kondo and Roberts, {S. K.} and Steers, {J. L.} and Krom, {R. A F} and Wiesner, {R. H.}",
year = "1997",
language = "English (US)",
volume = "3",
pages = "359--364",
journal = "Liver Transplantation",
issn = "1527-6465",
publisher = "John Wiley and Sons Ltd",
number = "4",

}

TY - JOUR

T1 - Liver transplantation for cryptogenic cirrhosis

AU - Charlton, M. R.

AU - Kondo, M.

AU - Roberts, S. K.

AU - Steers, J. L.

AU - Krom, R. A F

AU - Wiesner, R. H.

PY - 1997

Y1 - 1997

N2 - End-stage liver disease secondary to cryptogenic cirrhosis is the indication for orthotopic liver transplantation (OLT) in 7% to 14% of recipients. However, there are no reports documenting the outcome of OLT for this indication. The aim of this study was to determine (1) survival and (2) the incidence of histological recurrence of cryptogenic cirrhosis after OLT. Between March 1985 and December 1994, 660 OLTs were performed at our institution. Of these, 39 transplants for cryptogenic cirrhosis were in patients who met the following criteria: antinuclear antibody <1:40; negative anti-smooth muscle antibody, antimitochondrial antibody, polymerase chain reaction for hepatitis C virus, and hepatitis B surface antigen results; normal ceruloplasmin and α-1 antitrypsin phenotype; transferrin saturation < 65%; and liver biopsy specimen not suggestive of hemochromatosis or other known disorders. Histological recurrence was assessed with protocol liver biopsies in all patients who survived longer than 6 months. The mean age of cryptogenic recipients at the time of transplantation was significantly lower (40.6 years; range, 3 to 63 years) than that of noncryptogenic recipients (48.5 years; range, 1-70; P < .03). Median modified Child's-Pugh score was slightly higher for cryptogenic recipients at the time of transplantation (10.0 + 0.08 standard error of mean [SEM]), than for the noncryptogenic recipients (9.0 + 0.03 SEM; P < .02). Actuarial survival was 72% (+ 0.07 SEM) at 1 and 58% (+ 0.08 SEM) at 5 years for cryptogenic recipients compared with 89% at 1 and 80% at 5 years for noncryptogenic recipients. The difference in survival was significant (P < .001) at both 1 and 5 years. Among the 27 cryptogenic recipients surviving more than 6 months (mean follow-up, 5.5 years), 6 have persistent hepatitis histologically without apparent infectious, vascular, biliary, or drug origins. Four patients (15%) had chronic active hepatitis, and 2 (7%) had steatohepatitis. No cases of recurrent cryptogenic cirrhosis were seen. OLT for cryptogenic cirrhosis is associated with a poor outcome compared with other indications, hepatitis of uncertain origin occurred in 22% of cryptogenic recipients surviving longer than 6 months, and no evidence of recurrence of cryptogenic cirrhosis was seen thus far in follow-up.

AB - End-stage liver disease secondary to cryptogenic cirrhosis is the indication for orthotopic liver transplantation (OLT) in 7% to 14% of recipients. However, there are no reports documenting the outcome of OLT for this indication. The aim of this study was to determine (1) survival and (2) the incidence of histological recurrence of cryptogenic cirrhosis after OLT. Between March 1985 and December 1994, 660 OLTs were performed at our institution. Of these, 39 transplants for cryptogenic cirrhosis were in patients who met the following criteria: antinuclear antibody <1:40; negative anti-smooth muscle antibody, antimitochondrial antibody, polymerase chain reaction for hepatitis C virus, and hepatitis B surface antigen results; normal ceruloplasmin and α-1 antitrypsin phenotype; transferrin saturation < 65%; and liver biopsy specimen not suggestive of hemochromatosis or other known disorders. Histological recurrence was assessed with protocol liver biopsies in all patients who survived longer than 6 months. The mean age of cryptogenic recipients at the time of transplantation was significantly lower (40.6 years; range, 3 to 63 years) than that of noncryptogenic recipients (48.5 years; range, 1-70; P < .03). Median modified Child's-Pugh score was slightly higher for cryptogenic recipients at the time of transplantation (10.0 + 0.08 standard error of mean [SEM]), than for the noncryptogenic recipients (9.0 + 0.03 SEM; P < .02). Actuarial survival was 72% (+ 0.07 SEM) at 1 and 58% (+ 0.08 SEM) at 5 years for cryptogenic recipients compared with 89% at 1 and 80% at 5 years for noncryptogenic recipients. The difference in survival was significant (P < .001) at both 1 and 5 years. Among the 27 cryptogenic recipients surviving more than 6 months (mean follow-up, 5.5 years), 6 have persistent hepatitis histologically without apparent infectious, vascular, biliary, or drug origins. Four patients (15%) had chronic active hepatitis, and 2 (7%) had steatohepatitis. No cases of recurrent cryptogenic cirrhosis were seen. OLT for cryptogenic cirrhosis is associated with a poor outcome compared with other indications, hepatitis of uncertain origin occurred in 22% of cryptogenic recipients surviving longer than 6 months, and no evidence of recurrence of cryptogenic cirrhosis was seen thus far in follow-up.

UR - http://www.scopus.com/inward/record.url?scp=0030857206&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030857206&partnerID=8YFLogxK

M3 - Article

C2 - 9346764

AN - SCOPUS:0030857206

VL - 3

SP - 359

EP - 364

JO - Liver Transplantation

JF - Liver Transplantation

SN - 1527-6465

IS - 4

ER -