An evaluation of long-term outcomes after liver transplantation for cryptogenic cirrhosis

Liver Transpl. 2003 Sep;9(9):921-8. doi: 10.1053/jlts.2003.50165.


Patients with cryptogenic cirrhosis (CC) comprise a significant proportion of liver transplant recipients. Poor outcome after transplantation has been reported by some centers, with fibrosis occurring in a significant proportion of patients. Outcome of 46 patients with CC who underwent transplantation between 1989 and 1999 at King's College Hospital London were compared with time-matched recipients who underwent transplantation for hepatitis C virus (HCV) cirrhosis (n = 58) and patients with alcohol-related cirrhosis (AC, n = 53) during the same time period. Mean follow-up was 46 +/- 37 months for CC patients, 41 +/- 31 months for AC patients, and 49 +/- 31 months for HCV patients. No protocol liver biopsy specimens were obtained, and biopsies were performed only for investigation of biochemical abnormalities. Acute cellular rejection occurred in 30% of CC, 26% of AC, and 37% of HCV patients (P = NS). Overall patient and graft survival at 1 year was 85% and 80% for CC patients, 87% and 81% for AC patients, and 91% and 82% for patients with HCV (P = NS). Five-year patient and graft survival was 81% and 77% for CC patients, 60% and 48% for AC patients, and 79% and 57% for HCV patients (Log rank; P =.369). Twenty-two percent of CC patients had inflammation on last evaluable liver biopsy, compared with 25% of patients who underwent transplantation for AC and 68% of patients who underwent transplantation for HCV. No patient who underwent transplantation for CC had histologic evidence of cirrhosis on last evaluable biopsy, compared with 2% of patients who underwent transplantation for AC and 16% of patients who underwent transplantation for HCV (Chi-squared = 13.053, P =.0015). These results suggest that CC is a favorable indication for OLT and that although a proportion of patients develop inflammation in the liver allograft, this does not result in significant graft dysfunction or loss.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Evaluation Studies as Topic
  • Female
  • Follow-Up Studies
  • Graft Rejection / mortality
  • Graft Rejection / pathology
  • Graft Survival
  • Hepatitis C, Chronic / mortality
  • Hepatitis C, Chronic / surgery
  • Hepatitis, Alcoholic / mortality
  • Hepatitis, Alcoholic / surgery
  • Hepatitis, Chronic / mortality
  • Hepatitis, Chronic / surgery*
  • Humans
  • Liver Cirrhosis / mortality
  • Liver Cirrhosis / surgery*
  • Liver Transplantation / mortality*
  • Male
  • Middle Aged
  • Survival Analysis
  • Treatment Outcome