1194. Trends in viral hepatitis B and C among liver transplant recipients, United States, 2000-2010
Session: Poster Abstract Session: Non-CMV Viruses and Transplantation
Saturday, October 22, 2011
Room: Poster Hall B1
Background:  Liver transplants represent a costly, albeit infrequent outcome of end stage liver disease.  As the cohort of US residents with chronic viral hepatitis B and C infection age, complications of infection will substantially impact the healthcare system. Surveillance of liver transplants can reflect missed opportunities for secondary prevention.

Methods: We examined data from the Organ Procurement and Transplantation Network as of Mar 4, 2011 and selected liver transplants from Jan 2000 through Dec 2010. Transplant recipients were categorized as having viral hepatitis B, C, both, none, or pooled as recipients with viral hepatitis (RVH) and compared to recipients without viral hepatitis (not-RVH).

Results: From 2000 – 2010, a total of 65,891 liver transplants were reported in the United States. The number overall increased 25.8%, from 5,001 in 2000 to 6,291 in 2010 (p<0.001). Of the total, 35.9% of recipients had hepatitis C, 3.6% had hepatitis B, and 0.7% had both. During this time, there was little annual variation in the proportion of transplants associated with either or both viruses; however, transplants increased significantly among recipients with hepatitis C (20.7%; p<0.001) and decreased significantly among recipients with hepatitis B (-24.2%; p<0.001).  RVH were more likely than not-RVH to be slightly older (Me= 53 yrs vs 51 yrs; p<0.001), male (75.2% and 57.3%; p<0.001), have high school education or less (56.9% and 53.4%; p<0.001), or be of Asian race (6.3% and 2.9%; p<0.001). However, RVH were less likely than not-RVH to have been admitted to an ICU before the transplant surgery (11.1% and 18.8%; p<0.001).  Hospital length of stay was greater among RVH compared to not-RVH (Me=73 days and 63 days; p<0.001); death was significantly more frequent among RVH compared to not-RVH (27.0% and 21.0%; p<0.001).  Applying the mean cost of a hospitalization for a liver transplant ($122,862), in 2010 RVH had over $303 million in direct hospital costs.    

Conclusion: The small decline in hepatitis B-related liver transplants is encouraging; liver transplants should be routinely monitored to document the US burden of chronic viral hepatitis.  Preventing hepatitis related complications can reduce healthcare costs. 


Subject Category: V. Virology including clinical and basic studies of viral infections, including hepatitis

Monina Klevens, DDS, MPH1, Benjamin Kupronis, MPH2 and Ruth Jiles, PhD, MPH, MS1, (1)Div Viral Hepatitis, CDC, Atlanta, GA, (2)Centers for Disease Control and Prevention, Atlanta, GA

Disclosures:

M. Klevens, None

B. Kupronis, None

R. Jiles, None

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