Impact of hepatitis C virus status in pancreas transplantation: A case controlled study

Marsha R. Honaker, Robert J. Stratta, Agnes Lo, M. Francesca Egidi, M. Hosein Shokouh-Amiri, Hani P. Grewal, Rita R. Alloway, Lillian W. Gaber, Karen L. Hardinger, A. Osama Gaber

Research output: Contribution to journalReview article

13 Scopus citations

Abstract

Available data suggest that hepatitis C virus positive (HCV+) renal transplant patients may be at an increased risk of morbidity and mortality compared with HCV- patients. Limited data are available regarding the impact of HCV status in pancreas transplant patients. We compared the outcomes of 10 HCV+ patients undergoing pancreas transplantation (seven simultaneous kidney-pancreas, one pancreas after kidney, two pancreas alone) between 1/96 and 10/99 with 20 HCV- recipients that were matched for age, race, gender, timing of transplant, type of pancreas transplant, and surgical technique. Length of follow-up was not significantly different between the HCV+ group compared with the HCV- group (24 ± 14 vs. 20 ± 13 months; p = 0.45). There was a trend toward a higher incidence of all cause mortality in HCV+ recipients compared with HCV- recipients, 30 vs. 10%, respectively (p = 0.17). Additionally, the HCV+ recipients had a trend toward a higher incidence of sepsis-related mortality compared with HCV- recipients, 20 vs. 5%, respectively (p = 0.19). Renal allograft survival was 50% in the HCV+ group compared with 94% in the HCV- group . (p = 0.02). Pancreas allograft survival was not significantly different between the groups, 60 vs. 80%, respectively (p = 0.24). At 3, 6, 12 months, and end of follow-up, there were no differences in serum creatinine, amylase, C-peptide, or fasting glucose levels. However, there was a significantly higher incidence of proteinuria at last follow-up in the HCV+ recipients with a renal allograft when compared with HCV- recipients, 50 vs. 12.5%, respectively (p = 0.05). In order to maintain comparable glycemic control between the groups, there was a significant increase in oral hypoglycemic requirement in HCV+ recipients compared with HCV- recipients, 33 vs. 0%, respectively (p = 0.01). These data suggest that HCV+ pancreas transplant patients may be at an increased risk of graft dysfunction and morbidity. Further studies with more patients and longer follow-up are needed to fully define the impact of HCV status on pancreas graft survival and function.

Original languageEnglish (US)
Pages (from-to)243-251
Number of pages9
JournalClinical Transplantation
Volume16
Issue number4
DOIs
StatePublished - 2002

Keywords

  • Graft function
  • Graft survival
  • Hepatitis C
  • Kidney transplantation
  • Morbidity
  • Outcomes
  • Pancreas transplantation

ASJC Scopus subject areas

  • Transplantation
  • Immunology

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