Journal
TRANSPLANT INTERNATIONAL
Volume 26, Issue 11, Pages 1070-1079Publisher
WILEY
DOI: 10.1111/tri.12164
Keywords
hepatic; iron; mortality; transplantation
Categories
Funding
- Kelly Group
- Medical Research Council [MR/J006742/1] Funding Source: researchfish
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Recent data suggest an association of serum ferritin (SF) with waiting list (WL) and postliver transplant (LT) outcomes. To assess the predictive capacity of SF on pre- and post-LT outcomes, and to identify whether recipient or donor liver siderosis is associated with post-LT survival; a retrospective analysis of 1079 patients assessed for first LT, 2000-2007 was performed. Iron deposition in the liver tissue was assessed using a semi-quantitative grading system. Median age was 54 (18-82) years and 67% were male. Seventeen per cent had hepatocellular carcinoma (HCC). Median Model for End-stage Liver Disease MELD score was 14 (6-40), ferritin was 174g/l (4-4597) with 36.5% had a SFg/l. Age (OR=1.028) and MELD score (OR=1.158) were independently associated with WL mortality (P<0.001), whilst SF was not (P=NS). Age (OR=1.018), HCC (OR=1.542) and cold ischemia time (CIT)10h (OR=1.418) were independently associated with post-LT survival (P<0.05). Explant siderosis grade <2 was seen in 376 (71.7%) patients. Patients with explant siderosis grade 2 had inferior 12-month post-LT survival (P=0.030). Presence of graft siderosis (15.8% of patients) was not associated with survival. In conclusion, we found a limited role for SF as a prognostic indicator for pre- or post-transplant survival.
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