studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 1061A
pre- and post-operative achievement of SVR had better survival
rates after hepatic resection for HCV-related HCC.
Disclosures:
Norifumi Kawada - Grant/Research Support: BMS, Chugai, Kowa; Speaking
and Teaching: MSD, Janssen
The following authors have nothing to disclose: Shogo Tanaka, Shigekazu
Takemura, Akihiro Tamori, Masahiko Kinoshita, Shoji Kubo
1749
Effects of pre-transplant hepatitis C clearance on liver
transplantation listing and wait time – a single center
experience
Po-Hung Chen 1 , Mary G. Bowring 2 , Lauren M. Kucirka 2 , Christine
M. Durand 1 , Andrew Ofosu 2 , Alia S. Dadabhai 1 , James P. Hamilton
1 , Andrew M. Cameron 3 , Dorry L. Segev 3 , Mark S. Sulkowski 1 ,
Ahmet Gurakar 1 ; 1 Medicine, Johns Hopkins University, Baltimore,
MD; 2 Johns Hopkins University, Baltimore, MD; 3 Surgery, Johns
Hopkins University, Baltimore, MD
Background: The use of hepatitis C virus (HCV)-positive
allografts in viremic recipients helps expand the pool of
potential donors – especially at high usage LT centers – but
these organs are generally inappropriate for patients cleared
of chronic HCV. Despite recent advancements using new
direct-acting antivirals (DAA), no clear guidelines yet exist
regarding the optimal timing of HCV treatment peri-LT. The
present analysis aims to assess the associations of successful
pre-LT HCV treatment in the era of interferon-sparing DAA regimens
with LT listing and time on wait list. Methods: Data were
collected retrospectively for consecutive adults with HCV-related
liver disease who underwent cadaveric LT at the Johns Hopkins
Hospital from January 1, 2014 to April 5, 2015. Recipients
were grouped as “HCV Negative” or “HCV Positive” based on
serum HCV RNA status at LT. The decision to treat HCV pre-LT
was made by individual providers. Between-group comparisons
were made of key recipient and donor characteristics.
Results: There were 50 cadaveric LT for HCV-related liver disease,
32 (64%) of which were in “HCV Positive” group. Within
this group, 13 (41%) HCV-positive allografts were used. No
significant differences were noted between “HCV Negative”
and “HCV Positive” groups in age, gender, race, presence
of hepatocellular carcinoma, and MELD at organ allocation.
Among “Negative” recipients 11 (61%) had blood type O,
versus 12 (38%) in “Positive” group. Sixteen (89%) “Negative”
recipients were alive at 1 year post-LT, compared to 29
(91%) “Positive” patients (P = 0.8). (Table) Finally, concordant
HCV-negative recipient-donor pairs waited a median of
158 days (Q25-Q75: 13-296) before LT; HCV-positive pairs
waited 221 (26-241) days (P = 0.7). Conclusions: There were
no significant between-group differences, including time on
wait list, among recipients regardless of treatment with DAA
pre-LT. The use of HCV-positive organs in viremic recipients did
not adversely impact survival at one year. Larger studies are
needed to confirm whether these relationships hold true across
the entire spectrum of MELD and blood types at LT listing.
Disclosures:
Mark S. Sulkowski - Advisory Committees or Review Panels: Merck, AbbVie,
Janssen, Gilead, BMS; Grant/Research Support: Merck, AbbVie, Janssen, Gilead,
BMS
Ahmet Gurakar - Advisory Committees or Review Panels: Gilead; Grant/
Research Support: BMS
The following authors have nothing to disclose: Po-Hung Chen, Mary G. Bowring,
Lauren M. Kucirka, Christine M. Durand, Andrew Ofosu, Alia S. Dadabhai,
James P. Hamilton, Andrew M. Cameron, Dorry L. Segev
1750
Protective Birth Cohort Effect in Baby Boomers Despite
Presence of Poor Predictors
Ryan B. Perumpail 1 , Andy Liu 2 , Channa R. Jayasekera 1 , Zobair M.
Younossi 3,4 , Robert J. Wong 5 , Aijaz Ahmed 1 ; 1 Division of Gastroenterology
and Hepatology, Stanford University Medical Center,
Palo Alto, CA; 2 Medicine, Albert Einstein College of Medicine,
Bronx, NY; 3 Department of Medicine, Center for Liver Diseases,
Inova Fairfax Hospital, Falls Church, VA; 4 Betty and Guy Beatty
Center for Integrated Research, Inova Health System, Falls Church,
VA; 5 Division of Gastroenterology and Hepatology, Alameda
Health System, Highland Hospital, Oakland, CA
Background: Hepatitis C virus (HCV) is a leading etiology of
chronic liver disease in the U.S. Seventy-five percent of HCV
patients are of the baby boomer (BB) generation (born 1945-
1965). Our study aims to analyze the impact of the BB generation
on survival following liver transplantation (LT) in the
U.S. Methods: We conducted a retrospective cohort study
using population-based national data from the United Network
for Organ Sharing 1995-2012 registry to evaluate birth
cohort-specific (BB vs. non-BB) and etiology-specific (HCV vs.
non-HCV) impact on outcomes. Overall post-LT survival was
stratified by birth cohort and HCV status, and was evaluated
with Kaplan Meier methods and multivariate Cox proportional
hazards models. Results: From 1995 to 2012, the proportion
of LT waitlist registrations represented by BB patients increased
from 47.4% to 77.0%. These trends were primarily driven by
HCV, and BB patients accounted for 90% of HCV-related LT
waitlist registrants in 2012. Similar trends were seen among LT
recipients: BB patients accounted for 78.1% of all LT in 2012
compared to 21.9% among non-BB patients. Furthermore, BB
patients accounted for 91.1% of HCV-related LT. Among both
HCV and non-HCV patients, BB patients had significantly better
5-year post-LT survival (HCV: 69.5% vs. 64.2%, p< 0.001;
non-HCV: 79.8% vs. 74.2%, p