Clinical—liver, pancreas, and biliary tractSurvival After Liver Transplantation in Patients With Hepatic Iron Overload: The National Hemochromatosis Transplant Registry
Section snippets
Patients
Twelve liver transplantation centers participated in this study. The complete list of centers and participating investigators is shown in Appendix 1. Patients who had undergone their first liver transplantation prior to 1996 were eligible to enter this study. To be included, patients were required to have one of the following: a known diagnosis of hemochromatosis or hepatic iron overload prior to liver transplantation based on one of the following criteria: compatible hepatic iron stain (as ≥2+
Results
The characteristics of the study population are shown in Table 1. The mean age of the patients was 51 years, and 80% were male. HFE genotyping was available in 195 of the 260 patients (75%). The prevalence of HFE mutations in those with genotype available was 46%. Twenty-five patients (13% of those genotyped) had HH, as defined by presence of homozygous C282Y (n = 14) or compound heterozygous C282Y/H63D mutations (n = 11). Fifty-nine (30%) patients were “simple” heterozygotes, and 106 were wild
Discussion
The current report, to our knowledge, is the largest study to date examining survival after liver transplantation in a multicenter, nationwide cohort of patients with end-stage liver disease and hepatic iron overload. Moreover, this is the first detailed study examining the relationship between HFE mutations and outcome after liver transplantation while controlling for UNOS status and other prognostic factors. Our study demonstrated unequivocally that patients in the United States with HFE
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Supported by NIH grants DK 54698, DK 02957, and DK 38215.