title: Long-term outcome of patients transplanted with livers from hepatitis C-positive donors.
abstract: BACKGROUND
  The use of hepatitis C serology-positive donors has become an option in patients affected by hepatitis C (Hep C) end-stage liver disease. Previous studies with less than 1 year of follow-up have suggested that there is no difference in early patient and graft survival. The aim of our review is to confirm with a longer follow-up (a minimum of 1 year) that the use of these organs is safe and that patient and graft survival are comparable to those of patients with Hep C who received Hep C-negative grafts.
  
  
  METHODS
  Between 1985 and 1995, 213 patients were transplanted with a diagnosis of Hep C. Seventy-six patients were excluded from the study, 47 for insufficient follow-up and 29 because the diagnosis of recurrence was not certain. Twenty-two patients received Hep C+ donor grafts and 115 patients received Hep C-donor grafts. These two groups were evaluated to assess the rate and severity of recurrence by serial biopsies and to assess patient and graft survival.
  
  
  RESULTS
  Recurrent Hep C was documented by biopsy in 12 of 22 patients who received Hep C+ donor grafts. Of these 12 patients, 9 had mild chronic hepatitis, 2 had fibrosis, and 1 had cirrhosis. Ten of the 22 patients had normal biopsies. Of the patients who received Hep C- grafts, 48 of 115 had recurrent disease. Of these 48 patients, 23 had mild chronic hepatitis, 15 had fibrosis, and 10 had cirrhosis. Sixty-seven of 115 had normal biopsies. The recurrence rate was 54.55% in the Hep C+ donor grafts and 41.74% in the Hep C- donor grafts (P=NS). Patient and graft survival at 4 years after transplant were 83.9% and 71.9% in the Hep C+ donor grafts and 79.1% and 76.2% in the Hep C- donor grafts, respectively (P=NS).
  
  
  CONCLUSIONS
  Our study suggests that Hep C+ donors can be used with excellent long-term results and that the progression of the recurrent disease does not seem to be affected by the pre-existence of the Hep C virus in the donor.
authors.affiliation: Transplantation Services, Baylor University Medical Center, Dallas, Texas 75246, USA.
authors.forename: G
authors.initials: G
authors.lastname: Testa
authors.forename: R M
authors.initials: RM
authors.lastname: Goldstein
authors.forename: G
authors.initials: G
authors.lastname: Netto
authors.forename: O
authors.initials: O
authors.lastname: Abbasoglu
authors.forename: B K
authors.initials: BK
authors.lastname: Brooks
authors.forename: M F
authors.initials: MF
authors.lastname: Levy
authors.forename: B S
authors.initials: BS
authors.lastname: Husberg
authors.forename: T A
authors.initials: TA
authors.lastname: Gonwa
authors.forename: G B
authors.initials: GB
authors.lastname: Klintmalm
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D016174:Hepacivirus; D006526:Hepatitis C / Q000473:pathology / Q000821:virology*; D006801:Humans; D008099:Liver / Q000473:pathology / Q000821:virology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome