Liver transplantation from anti-hepatitis C virus-positive donors: our experience

Transplant Proc. 2012 Jul-Aug;44(6):1475-8. doi: 10.1016/j.transproceed.2012.05.012.

Abstract

Background: Hepatitis C (HCV) is among the most common causes of end-stage liver disease worldwide. The donor shortage leads us to consider alternative organ sources such as HCV-positive donors. The outcomes of these transplants must be evaluated thoroughly since there is universal recurrence of disease among HCV-positive liver transplant recipients.

Methods: From January 2005 to April 2011, we performed 143 liver transplants (OLT) to treat end-stage liver disease secondary to HCV infection. Thirteen patients (9,1%) received livers from HCV-positive donors. A control group consisted of 130 HCV-positive patients who underwent OLT during the same period with organs from HCV-negative donors. Donor HCV status was assessed by 2 tests: HCV antibodies and viral load. Not only recipient and graft survivals were analyzed, but also frequency, timing and severity of hepatitis recurrence.

Results: Among 143 transplants performed in HCV-positive recipients during a 6-year period from January 1, 2005, to April 30, 2011, 9.1% of patients received an organ from an anti-HCV-positive donor, 72.7% of whom showed a negative viral load. The vast majority (80%) of our patients suffered hepatitis during their follow-up, 22.4% of which were severe cases.

Conclusions: No significant difference in patient or graft survival was observed between the 2 groups. A high percentage of grafts with initial positive serology for HCV showed no viral replication. Grafts from HCV-positive donors can be considered to be a safe, effective source for liver donation.

MeSH terms

  • Biomarkers / blood
  • Chi-Square Distribution
  • Donor Selection*
  • End Stage Liver Disease / mortality
  • End Stage Liver Disease / surgery*
  • End Stage Liver Disease / virology
  • Female
  • Graft Survival
  • Hepacivirus / genetics
  • Hepacivirus / growth & development
  • Hepacivirus / immunology*
  • Hepatitis C / blood
  • Hepatitis C / complications*
  • Hepatitis C / diagnosis
  • Hepatitis C / mortality
  • Hepatitis C Antibodies / blood*
  • Humans
  • Kaplan-Meier Estimate
  • Liver Transplantation* / adverse effects
  • Liver Transplantation* / mortality
  • Male
  • RNA, Viral / blood
  • Recurrence
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Spain
  • Time Factors
  • Tissue Donors / supply & distribution*
  • Treatment Outcome
  • Viral Load
  • Virus Replication

Substances

  • Biomarkers
  • Hepatitis C Antibodies
  • RNA, Viral