Outcomes of liver transplantation for cryptogenic cirrhosis

A single-center study of 71 patients

A. Sanjeevi, E. Lyden, B. Sunderman, R. Weseman, R. Ashwathnarayan, Sandeep Mukherjee

Research output: Contribution to journalReview article

41 Citations (Scopus)

Abstract

Cryptogenic cirrhosis (CC) is emerging as an important indication for orthotoptic liver transplantation (OLT) in the United States. Our aim was to identify risk factors associated with nonalcoholic steatohepatitis (NASH) in patients with CC and to evaluate outcomes following OLT. Patients and methods. A chart review was performed on patients transplanted for CC at the University of Nebraska Medical Center between October 1993 and May 2003. Results. Seventy-one patients were identified (37 were men and 34 women). Average age was 53.5 years. Mean cholesterol and triglyceride levels increased from 174.8 to 222.3 mg/dL (P <.05) and from 162.60 to 279.66 mg/dL (P <.05), respectively. The prevalence of diabetes mellitus also increased from 37.14% to 54.93% (P <.05). Incidental hepatocellular carcinoma was present in six patients and high-grade dysplasia in one patient. Steatohepatitis developed in eight patients and recurrent cryptogenic disease in four, of whom one required retransplantation for decompensated liver disease. Rejection occurred in 24 patients. Cumulative incidence of graft failure at 1 year was 4% (95% CI 0% to 10%) and at 5 years was 7% (95% CI 0% to 18%). Survival at 1 year was 85% (95% CI 77% to 94%) and at 5 years was 73% (95% CI between 61% to 86%). Conclusions. Cryptogenic liver disease is an important cause of decompensated cirrhosis; NASH appears to be an intermediate stage in the development of this disease in a subset of patients. Short-term and 5-year survival rates in this series appear comparable to other liver transplant recipients, supporting liver transplantation as an acceptable treatment for CC.

Original languageEnglish
Pages (from-to)2977-2980
Number of pages4
JournalTransplantation Proceedings
Volume35
Issue number8
DOIs
StatePublished - Dec 2003
Externally publishedYes

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Liver Transplantation
Liver Diseases
Cryptogenic Cirrhosis
Fatty Liver
Hepatocellular Carcinoma
Diabetes Mellitus
Triglycerides
Fibrosis
Survival Rate
Cholesterol
Transplants
Survival
Liver
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation

Cite this

Outcomes of liver transplantation for cryptogenic cirrhosis : A single-center study of 71 patients. / Sanjeevi, A.; Lyden, E.; Sunderman, B.; Weseman, R.; Ashwathnarayan, R.; Mukherjee, Sandeep.

In: Transplantation Proceedings, Vol. 35, No. 8, 12.2003, p. 2977-2980.

Research output: Contribution to journalReview article

Sanjeevi, A. ; Lyden, E. ; Sunderman, B. ; Weseman, R. ; Ashwathnarayan, R. ; Mukherjee, Sandeep. / Outcomes of liver transplantation for cryptogenic cirrhosis : A single-center study of 71 patients. In: Transplantation Proceedings. 2003 ; Vol. 35, No. 8. pp. 2977-2980.
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title = "Outcomes of liver transplantation for cryptogenic cirrhosis: A single-center study of 71 patients",
abstract = "Cryptogenic cirrhosis (CC) is emerging as an important indication for orthotoptic liver transplantation (OLT) in the United States. Our aim was to identify risk factors associated with nonalcoholic steatohepatitis (NASH) in patients with CC and to evaluate outcomes following OLT. Patients and methods. A chart review was performed on patients transplanted for CC at the University of Nebraska Medical Center between October 1993 and May 2003. Results. Seventy-one patients were identified (37 were men and 34 women). Average age was 53.5 years. Mean cholesterol and triglyceride levels increased from 174.8 to 222.3 mg/dL (P <.05) and from 162.60 to 279.66 mg/dL (P <.05), respectively. The prevalence of diabetes mellitus also increased from 37.14{\%} to 54.93{\%} (P <.05). Incidental hepatocellular carcinoma was present in six patients and high-grade dysplasia in one patient. Steatohepatitis developed in eight patients and recurrent cryptogenic disease in four, of whom one required retransplantation for decompensated liver disease. Rejection occurred in 24 patients. Cumulative incidence of graft failure at 1 year was 4{\%} (95{\%} CI 0{\%} to 10{\%}) and at 5 years was 7{\%} (95{\%} CI 0{\%} to 18{\%}). Survival at 1 year was 85{\%} (95{\%} CI 77{\%} to 94{\%}) and at 5 years was 73{\%} (95{\%} CI between 61{\%} to 86{\%}). Conclusions. Cryptogenic liver disease is an important cause of decompensated cirrhosis; NASH appears to be an intermediate stage in the development of this disease in a subset of patients. Short-term and 5-year survival rates in this series appear comparable to other liver transplant recipients, supporting liver transplantation as an acceptable treatment for CC.",
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T1 - Outcomes of liver transplantation for cryptogenic cirrhosis

T2 - A single-center study of 71 patients

AU - Sanjeevi, A.

AU - Lyden, E.

AU - Sunderman, B.

AU - Weseman, R.

AU - Ashwathnarayan, R.

AU - Mukherjee, Sandeep

PY - 2003/12

Y1 - 2003/12

N2 - Cryptogenic cirrhosis (CC) is emerging as an important indication for orthotoptic liver transplantation (OLT) in the United States. Our aim was to identify risk factors associated with nonalcoholic steatohepatitis (NASH) in patients with CC and to evaluate outcomes following OLT. Patients and methods. A chart review was performed on patients transplanted for CC at the University of Nebraska Medical Center between October 1993 and May 2003. Results. Seventy-one patients were identified (37 were men and 34 women). Average age was 53.5 years. Mean cholesterol and triglyceride levels increased from 174.8 to 222.3 mg/dL (P <.05) and from 162.60 to 279.66 mg/dL (P <.05), respectively. The prevalence of diabetes mellitus also increased from 37.14% to 54.93% (P <.05). Incidental hepatocellular carcinoma was present in six patients and high-grade dysplasia in one patient. Steatohepatitis developed in eight patients and recurrent cryptogenic disease in four, of whom one required retransplantation for decompensated liver disease. Rejection occurred in 24 patients. Cumulative incidence of graft failure at 1 year was 4% (95% CI 0% to 10%) and at 5 years was 7% (95% CI 0% to 18%). Survival at 1 year was 85% (95% CI 77% to 94%) and at 5 years was 73% (95% CI between 61% to 86%). Conclusions. Cryptogenic liver disease is an important cause of decompensated cirrhosis; NASH appears to be an intermediate stage in the development of this disease in a subset of patients. Short-term and 5-year survival rates in this series appear comparable to other liver transplant recipients, supporting liver transplantation as an acceptable treatment for CC.

AB - Cryptogenic cirrhosis (CC) is emerging as an important indication for orthotoptic liver transplantation (OLT) in the United States. Our aim was to identify risk factors associated with nonalcoholic steatohepatitis (NASH) in patients with CC and to evaluate outcomes following OLT. Patients and methods. A chart review was performed on patients transplanted for CC at the University of Nebraska Medical Center between October 1993 and May 2003. Results. Seventy-one patients were identified (37 were men and 34 women). Average age was 53.5 years. Mean cholesterol and triglyceride levels increased from 174.8 to 222.3 mg/dL (P <.05) and from 162.60 to 279.66 mg/dL (P <.05), respectively. The prevalence of diabetes mellitus also increased from 37.14% to 54.93% (P <.05). Incidental hepatocellular carcinoma was present in six patients and high-grade dysplasia in one patient. Steatohepatitis developed in eight patients and recurrent cryptogenic disease in four, of whom one required retransplantation for decompensated liver disease. Rejection occurred in 24 patients. Cumulative incidence of graft failure at 1 year was 4% (95% CI 0% to 10%) and at 5 years was 7% (95% CI 0% to 18%). Survival at 1 year was 85% (95% CI 77% to 94%) and at 5 years was 73% (95% CI between 61% to 86%). Conclusions. Cryptogenic liver disease is an important cause of decompensated cirrhosis; NASH appears to be an intermediate stage in the development of this disease in a subset of patients. Short-term and 5-year survival rates in this series appear comparable to other liver transplant recipients, supporting liver transplantation as an acceptable treatment for CC.

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DO - 10.1016/j.transproceed.2003.10.059

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JO - Transplantation Proceedings

JF - Transplantation Proceedings

SN - 0041-1345

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