studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 823A
HBc, 34% for anti-HBs, 19.8% for anti-HBc-/anti-HBs+, 79.4%
for anti-HAV(IgG), and 91.7% for anti-VZV(IgG). Conclusion:
Despite vaccination recommendations in cirrhotic patients
awaiting LT, only few patients are informed and vaccinated
while on the LT waiting list in a large Parisian center. Serological
protection for VZV and HAV was high (91.7 and 79.4
respectively), but it was low for HBV (34%), demonstrating the
urgent need of vaccination management in this population.
Disclosures:
Pascal Lebray - Grant/Research Support: Merck, astellas, Biotest, BMS; Speaking
and Teaching: Janssen, MSD, Gilead
The following authors have nothing to disclose: Mazzola Alessandra, Margherita
Tran Minh, Raluca Pais, Denis Bernard, Claire Goumard, Yvon Calmus, Filomena
Conti
1240
Increase in Red Cell Distribution Width Post Liver Transplant
is Associated with Patient Mortality
Thure Caire 1 , Kirbylee K. Nelson 2 , R. Todd Stravitz 4 , Ambuj
Kumar 2 , Nyingi M. Kemmer 3 ; 1 Gastroenterology, USF, Brandon,
FL; 2 Internal Medicine, USF, Tampa, FL; 3 Hepatology, Tampa General
Medical Group, Tampa, FL; 4 VCU, Richmond, VA
Background: Following liver transplantation (LT), patients are at
significant risk of mortality, however, prognostication following
LT is limited. The red cell distribution width (RDW) is a measure
of anisocytosis, and has been associated with morbidity and
mortality in several chronic diseases associated with chronic
systemic inflammation. The association of changes in RDW with
mortality in patients following transplant surgery is unknown.
As a potential surrogate for immunopathology, we hypothesize
an increase in RDW may be positively correlated with mortality
risk, therefore, the aim of this study is to determine the association
between changes in RDW following LT and patient mortality.
Methods: We performed a retrospective cohort study of all
LT recipients performed at our center from Jan 1 2012 – Dec
31 2012. The data collected included demographics (age,
gender, ethnicity/race, indication for LT), pre-transplant RDW
lab data (MELD score, hematologic parameters including MCV
and RDW, Liver panel, renal profile) with a 24 month follow-up
period including lab data at 6 months post-LT, and mortality 2
years post-LT. We retrospectively analyzed data for associations
with survival. Our primary end point was association of
change in RDW (pre-LT to 6 months post-LT) with post-transplant
mortality at 2 years. Statistical analysis was done using chisquare,
fischer exact test, regression analysis. A p-value 30kg/m 2 (OR 1.089, p = 0.048),
use of rapamycin (OR 9.898 p < 0.001), prior intra-arterial
HCC therapy (OR 3.761, p < 0.001), take back surgery (OR
9.038, p < 0.001), and cold ischemic time (OR 1, p = 0.209)
were considered significant. On multivariate analysis, only biologic
MELD at LT (OR 0.896, p = 0.028), BMI>30kg/m 2 (OR
1.122, p = 0.043), take back within 1 st month (OR 14.559,
p < 0.001), and rapamycin use (OR 12.450, p < 0.001)
remained significant. Pre-LT intra-arterial therapy was not a
significant predictor on multivariate analysis (OR 2.546, p =
0.140). Conclusion: Pre-transplant intra-arterial HCC therapies
to downstage into or maintain potential LT recipients within
Milan criteria are not associated with increased prevalence of
HAT post-LT. With respect to pre-LT HCC intra-arterial treatment
factors, no increased risk for HAT is conferred with modality
(chemo vs. radio-embolization), number of sessions, or number
of HCC foci.
Disclosures:
Anil B. Seetharam - Advisory Committees or Review Panels: Bristol Meyers
Squibb; Speaking and Teaching: Gilead, Janssen, Merck, Bayer
The following authors have nothing to disclose: Mark Pedersen, Meera Ramanathan,
Myunghan Choi