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Survival in patients with Child-Pugh class C cirrhosis: Analysis of the liver transplant registry in Japan
- Source :
- Hepatology Research. 47:1155-1164
- Publication Year :
- 2017
- Publisher :
- Wiley, 2017.
-
Abstract
- Aim Aim: To clarify the survival and prognostic factors in patients with Child–Turcotte–Pugh class C (CTP-C) cirrhosis. Methods From all candidates for deceased donor liver transplantation in Japan between 2007 and 2015, 1014 adult patients with CTP-C cirrhosis were retrospectively enrolled in this study. The hazard ratio (HR) of factors associated with mortality was estimated by the Cox proportional hazard model. The survival probabilities were evaluated by Kaplan–Meier analysis and the log–rank test. Results Median survival time of the entire cohort was 475 days. Univariate analysis identified age, CTP, Model for End-Stage Liver Disease (MELD) score, and primary biliary cholangitis (PBC) as significant variables associated with mortality and hepatitis B virus (HBV) infection as a close-to-significant variable. Multivariate analysis revealed that age-adjusted mortality risk increased by 59% and 12% per 1 score step up in CTP and MELD scores, respectively. The HRs for HBV infection and PBC were significant after adjustment for age and CTP score, and they showed a 26% lower risk and an 83% higher risk than hepatitis C virus (HCV) infection, respectively. After adjustment for age and MELD score, the HR was also significant for HBV infection, but lost statistical significance for PBC. The survival curves were well stratified by both CTP or MELD score and revealed significant difference in both HBV infection and PBC as compared to HCV infection. Conclusions In patients with CTP-C cirrhosis, CTP and MELD scores could well stratify the patients’ survival, and HBV infection and PBC as etiologies have an impact on survival.
- Subjects :
- Hepatitis B virus
medicine.medical_specialty
Cirrhosis
Hepatology
business.industry
Proportional hazards model
viruses
medicine.medical_treatment
Hazard ratio
Liver transplantation
medicine.disease
medicine.disease_cause
Gastroenterology
digestive system diseases
03 medical and health sciences
Liver disease
0302 clinical medicine
Infectious Diseases
030220 oncology & carcinogenesis
Internal medicine
medicine
030211 gastroenterology & hepatology
Child-Pugh Class C
business
Survival analysis
Subjects
Details
- ISSN :
- 13866346
- Volume :
- 47
- Database :
- OpenAIRE
- Journal :
- Hepatology Research
- Accession number :
- edsair.doi...........e99a1fc8834ae6eee842a9517c38514a