In patients who undergo liver transplantation because of Hepatitis C virus (HCV)-related Cirrhosis, donor age is inversely related to survival at 3 months, but has no effect on long-term survival, new research shows.

The study also indicates treatment with azathioprine is linked to increased long-term survival, according to the report in the journal Liver Transplantation.

Virtually all HCV-infected patients who undergo liver transplantation experience reinfection, but the severity of HCV recurrence is variable.

In recent years, survival and HCV recurrence seems to be worsening among transplanted patients, the researchers explain. Although donor age has been thought to play a role, it remains unclear if donor age has any effect on early or late mortality.

To investigate, Dr. Andrew K. Burroughs, from the Royal Free Hospital in London, and colleagues analyzed data from 193 HCV cirrhotic patients who received a liver transplant. The average follow-up period was 38 months.

As noted, donor age had no effect on survival after 3 months post-transplantation. However, the presence of liver cancer before transplantation and not using maintenance azathioprine therapy were associated with decreased long-term survival.

Donor age also had no effect on the risk of severe fibrosis. Likewise, the year of transplantation did not influence this outcome, whereas hepatitis flare raised the risk and maintenance steroids decreased it.

“Donor age is probably not the most important factor determining the severity of HCV recurrence after liver transplantation,” Burroughs told Reuters Health. “The results suggest that we should look at the impact of immunosuppression more carefully. And, in fact, trials are underway doing just that.”

SOURCE: Liver Transplantation, April 2005.