Implications of Treating Hepatitis C Virus Infection Among Patients Awaiting Cadaveric Liver Transplant: A Single-Center Experience

Exp Clin Transplant. 2015 Nov:13 Suppl 3:7-10. doi: 10.6002/ect.tdtd2015.L16.

Abstract

Objectives: We examined hepatitis C virus positivity among the donors in our center to investigate whether hepatitis C treatment affected liver transplant Model for End-Stage Liver Disease.

Materials and methods: We retrospectively reviewed all deceased-donor liver transplants performed between January 2013 and December 2014 at our center, with the primary indication of hepatitis C virus. Baseline demographic and laboratory characteristics of recipients and donors were collected. Statistical analyses were done with P values ≤ .05 considered significant.

Results: Seventy-five liver transplants were performed, and 62 of them were hepatitis C virus RNA-positive at the time of liver transplant donor offer. In 2013, during the Pre-Direct Antiviral Agents era, 14 of 33 hepatitis C virus RNA-positive recipients (42%) were matched to hepatitis C virus-positive donors. During the Direct Antiviral Agents era in 2014, this ratio was 38% (11/29) (P = .72). The mean Model for End-Stage Liver Disease at transplant of the 62 hepatitis C virus RNA-positive recipients was 29, whereas the mean Model for End-Stage Liver Disease of 13 hepatitis C virus RNA-negative recipients was 31. This was not statistically significant (P = .25).

Conclusions: Although hepatitis C virus treatment before liver transplant is an attractive option to eliminate the risk of complications because of recurrent hepatitis C virus after liver transplant, its potential effect on limiting the donor pool for the recipient must also be considered. In our observation, 40% of our donor pool consists of hepatitis C virus-positive donors. Further multiregional studies are warranted to verify this observation and to see the potential effect of direct antiviral agent treatment into waiting times and the Model for End-Stage Liver Disease at organ allocation.

Publication types

  • Lecture

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Baltimore
  • Biomarkers / blood
  • Donor Selection*
  • End Stage Liver Disease / diagnosis
  • End Stage Liver Disease / surgery*
  • End Stage Liver Disease / virology
  • Hepacivirus / drug effects*
  • Hepacivirus / genetics
  • Hepatitis C, Chronic / blood
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / diagnosis
  • Hepatitis C, Chronic / drug therapy*
  • Humans
  • Liver Transplantation / adverse effects
  • Liver Transplantation / methods*
  • Middle Aged
  • RNA, Viral / blood
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Tissue Donors / supply & distribution*
  • Treatment Outcome
  • Waiting Lists*

Substances

  • Antiviral Agents
  • Biomarkers
  • RNA, Viral