Survival After Liver Transplantation Using Hepatitis C Virus‐Positive Donor Allografts: Case‐Controlled Analysis of the UNOS Database

Abstract

This is the first population-based analysis to show that after adjusting for donor and recipient characteristics there was no difference in graft or patient survival with the use of HCV+ donor liver allografts compared to HCV- donor liver allografts.

Extended criteria donors in liver transplantation Part I: reviewing the impact of determining factors

“…However, it has been clearly shown that the survival and progression of HCV disease is similar to HCV negative allografts [70]. Therefore, HCV+ grafts are increasingly used by transplant centres [71].…”

“…The use of these liver grafts has been associated with higher rates of graft failure and biliary complication, particularly ischemic type cholangiopathy, compared with donation after brain death (DBD) allografts [84]. Optimum outcome has been shown if the WIT does not exceed 30 minutes, the CIT is limited to less than 8 hours, and younger donors being used (<50 years) [71]. There were no biliary or vascular complications and patient and graft survival is 100% at a median follow-up of 41.8 months (1.7-74 months) [89].…”

Matching donor to recipient in liver transplantation: Relevance in clinical practice

“…HBV: Hepatitis B virus. equivalent results in terms of frequency and severity of HCV recurrence, graft and patient survival [50,51] . Though the patient numbers in these studies are small and they are all retrospective studies, the evidence is promising.…”

“…They found that increasing number of mismatches was associated with increased risk of acute rejection though the graft survival rates were similar. In contrast, Muroetal [51] analysed data from 242 liver transplants and reported that matching at HLA-A locus increased the risk of graft failure. There is hence a lack of clarity regarding the relevance of HLA matching in LT.…”

Expanded Criteria Donors

“…35 UNOS/OPTN registry analysis has shown comparable patient and graft survival for recipients of HCVAb+ versus HCVAb− grafts from 1994 to 2008. 99,100 Whether grafts from HCVAb+ donors are associated with more rapid HCV recurrence remains controversial. In 1 multicenter study of = US transplant centers, recipients of HCVAb+ (n = 99) compared with HCVAb− (n = 1107) liver recipients experienced a 58% increased risk of advanced fibrosis, defined as Ludwig-Batts stage 3 or 4 disease.…”