Outcome of liver transplantation in hepatitis C virus-infected patients who received hepatitis C virus-infected grafts.
OBJECTIVE
The present organ shortage has brought into question the suitability of hepatitis C virus (HCV)-positive grafts. This study reviewed the outcome of such transplantations in our institution.


METHODS
Twenty-three HCV-positive patients who underwent orthotopic liver transplantation (OLT) for end-stage liver disease with HCV-positive grafts in 1992-1995 were studied. Only patients who survived more than 30 days were included in the analysis. Control group included 169 patients who underwent transplantation for HCV-related cirrhosis and received HCV-negative organs.


RESULTS
Patients who received HCV-infected organs had a cumulative survival rate of 89% and 72% at 1 and 5 years, respectively, vs. 88% and 73% for the control group (NS). There was no difference in graft survival, incidence of cirrhosis, mean hepatitis activity index score, fibrosis, or mean activity of serum transaminases. There was a trend toward lower incidence of recurrent hepatitis C in the study group compared with control (21% vs. 23% at 1 year and 47% vs. 64% at 5 years; NS). Patients in whom the donor strain became predominant after transplantation had significantly longer disease-free survival than patients who retained their own HCV strain (P < 0.003).


CONCLUSIONS
HCV-infected livers transplanted into HCV-infected recipients do not appear to convey a worse outcome in the initial years after OLT than HCV-negative grafts.
Vargas
H E
HE
Division of Gastroenterology and Hepatology, T. E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. hvargas@pitt.edu
Laskus
T
T
Wang
L F
LF
Lee
R
R
Radkowski
M
M
Dodson
F
F
Fung
J J
JJ
Rakela
J
J
D000328:Adult; D000368:Aged; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification*; D006526:Hepatitis C / Q000601:surgery*; D006801:Humans; D008099:Liver / Q000821:virology*; D008103:Liver Cirrhosis / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016019:Survival Analysis; D016896:Treatment Outcome