Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
Transplantation. 2012 Jul 27;94(2):178-84. doi: 10.1097/TP.0b013e318253f7fa.
Black recipients undergoing liver transplantation (LT) for hepatitis C virus (HCV) have decreased patient and graft survival compared with white recipients, a finding that is primarily limited to black recipients of livers from white donors. The cause(s) for these discrepant outcomes are unclear but may be related to HCV disease recurrence. The rates of HCV-related disease recurrence and liver fibrosis progression among black and white liver transplant recipients have not been investigated.
In this study, we compared liver fibrosis progression between 105 black and 364 white recipients after HCV-related LT in a multisite cohort study and assessed the impact of donor race.
At 6, 12, and 24 months after LT, there was a significantly higher percentage in the black recipient/white donor (B/W) group with severe fibrosis, defined as stage 3 or 4 (F3/F4), compared with all other recipient/donor race combinations. The adjusted odds ratio of developing F3/F4 for the B/W group was 2.54 (1.49-4.69; reference group, white recipient/white donor). Black recipients with black donors demonstrated a similar rate of progression to F3/F4 as white recipients. Patient survival was also decreased in the B/W group compared with other recipient/donor race combinations.
African American recipients with white donors have more severe fibrosis progression after HCV-related LT. The mechanisms responsible for accelerating fibrosis progression in this high-risk race-mismatched group need to be investigated.
与白人受者相比，接受 HCV 相关肝移植（LT）的黑人受者的患者和移植物存活率降低，这一发现主要限于从白人供者接受肝脏的黑人受者。这些不一致结果的原因尚不清楚，但可能与 HCV 疾病复发有关。尚未研究 HCV 相关疾病复发和肝纤维化进展在黑人和白人肝移植受者中的发生率。
在这项多中心队列研究中，我们比较了 105 名黑人 HCV 相关 LT 受者和 364 名白人受者的肝纤维化进展情况，并评估了供者种族的影响。
在 LT 后 6、12 和 24 个月，与所有其他受者/供者种族组合相比，黑受者/白供者（B/W）组中严重纤维化（定义为 3 或 4 期[F3/F4]）的比例显著更高。B/W 组发生 F3/F4 的调整比值比为 2.54（1.49-4.69；参考组为白受者/白供者）。黑受者与黑供者的 F3/F4 进展率与白受者相似。与其他受者/供者种族组合相比，B/W 组的患者生存率也降低。
与白人供者相比，接受 HCV 相关 LT 的非裔美国黑人受者的纤维化进展更严重。需要研究导致这一高风险种族错配组纤维化进展加速的机制。
