With Induction, Donor Age, Recipient Age > 60, Female Gender, and Rejection Hinder Patient Survival after Liver Transplantation for HCV. Donor Age and Rejection Increase Severe Fibrosis, Whereas rATG May Be Protective

M. Montenovo, J. Brandenberger, R. Bakthavatsalam, J. Haldorson, A. Dick, J. Perkins, L. Yu, C. Landis, I. Liou, R. Bhattacharya, R. Carithers, J. Reyes, S. Rayhill

University of Washington, Seattle

Meeting: 2013 American Transplant Congress

Abstract number: B1072

As our center uses induction therapy in all OLTX recipients, we sought to examine the risk factors important for survival and fibrosis in OLTX for HCV. Methods: All 385 patients with documented HCV transplanted at our center from 1/1/2000 through 1/1/2009 (to allow for 3 years follow up) were analyzed using our longitudinal database. Induction was given to 367 recipients: either basiliximab (Simulect) n = 276 or rabbit ATG (rATG) n = 91. Clinical and surveillance biopsies were analyzed using the Batts Ludwig scale to characterize HCV activity (grade: 0-4) and fibrosis (stage: 0-4). Statistics: t test, Chi square, Log rank and Cox proportional hazards. Results: Multivariate model: female gender, recipient age > 60, donor age, and rejection appear to be important risk factors for patient survival.


Risk Factor	Risk Ratio	p value
Rejection	1.6	0.03
Female Gender	2.1	0.0001
Recipient Age ≥ 60	1.9	0.01
Donor Age	1.02	0.007
rATG vs. Simulect	0.8	0.4

rATG vs. Simulect had no no significant effect on survival, even when stratified for donor or recipient age.

Recipient age and gender were not assiciated with increased fibrosis, but both rejection (28% vs. 40%, p=0.5) and donor age ≥ 50 (26% vs. 44%, p=0.008) were associated with severe (≥ stage 3) fibrosis. rATG seemed to be protective (21% vs. Simulect 33%, p=0.04). Conclusions: rATG induction does not seem to be deleterious and may be associated with decreased fibrosis. Donor age and rejection are significant risk factors for worse survival in OLTX for HCV and are associated with increased fibrosis. Advanced recipient age and female gender are risk factors, but do not appear to be associated with increased fibrosis.

To cite this abstract in AMA style:

Montenovo M, Brandenberger J, Bakthavatsalam R, Haldorson J, Dick A, Perkins J, Yu L, Landis C, Liou I, Bhattacharya R, Carithers R, Reyes J, Rayhill S. With Induction, Donor Age, Recipient Age > 60, Female Gender, and Rejection Hinder Patient Survival after Liver Transplantation for HCV. Donor Age and Rejection Increase Severe Fibrosis, Whereas rATG May Be Protective [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/with-induction-donor-age-recipient-age-60-female-gender-and-rejection-hinder-patient-survival-after-liver-transplantation-for-hcv-donor-age-and-rejection-increase-severe-fibrosis-whereas-ra/. Accessed May 17, 2025.

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