Transplantation of hepatitis C–positive livers in hepatitis C–positive patients is equivalent to transplanting hepatitis C–negative livers

• Published in: Liver transplantation Vol. 7; no. 9; pp. 762 - 768
• Main Authors: Marroquin, Carlos E., Marino, Gustavo, Kuo, Paul C., Plotkin, Jeffrey S., Rustgi, Vinod K., Lu, Amy D., Edwards, Erick, Taranto, Sarah, Johnson, Lynt B.
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Elsevier Inc 01-09-2001; W.B. Saunders
• Subjects: Blood; Demography; Donors; Female; Graft Rejection - epidemiology; Graft Rejection - etiology; Graft Rejection - mortality; Grafts; Hepacivirus - isolation & purification; Hepatitis C; Hepatocellular carcinoma; Humans; Incidence; Liver - virology; Liver diseases; Liver Transplantation; Male; Middle Aged; Mortality; Multivariate Analysis; Regression analysis; Rejection; Retrospective Studies; Reviews; Survival; Treatment Outcome
• ISSN: 1527-6465; 1527-6473
• DOI: 10.1053/jlts.2001.27088

A significant number of patients with end-stage liver disease secondary to hepatitis C die of disease-related complications. Liver transplantation offers the only effective alternative. Unfortunately, organ demand exceeds supply. Consequently, some transplant centers have used hepatitis C virus–positive (HCV
+) donor livers for HCV
+ recipients. This study reviews the clinical outcome of a large series of HCV
+ recipients of HCV
+ liver allografts and compares their course with that of HCV
+ recipients of HCV-negative (HCV
−) allografts. The United Network for Organ Sharing Scientific Registry was reviewed for the period from April 1, 1994, to June 30, 1997. All HCV
+ transplant recipients were analyzed. Two groups were identified: a group of HCV
+ recipients of HCV
+ donor livers (n = 96), and a group of HCV
+ recipients of HCV
− donor livers (n = 2,827). A multivariate logistic regression model was used to determine the odds of graft failure and patient mortality, and unadjusted graft and patient survival were determined using the Kaplan-Meier method. There were no differences in demographic criteria between the groups. A greater percentage of patients with hepatocellular carcinoma received an HCV
+ allograft (8.3%
v 3.1%;
P = .01). Patient survival showed a significant difference for the HCV
+ group compared with the HCV
− group (90%
v 77%;
P = .01). Blood type group A, group B, group O incompatibility was significant, with 4.2% incompatibility in the HCV
+ group and only 1.3% in the HCV
− group (
P = .04). Donor hepatitis C status does not impact on graft or patient survival after liver transplantation for HCV
+ recipients. Their survival was equivalent, if not better, compared with the control group. Using HCV
+ donor livers for transplantation in HCV
+ recipients safely and effectively expands the organ donor pool. (
Liver Transpl 2001;7:762-768.)