Liver transplantation using young pediatric donor grafts in adults with hepatitis C infection.
BACKGROUND
The impact of using grafts from donor's age less than or equal to 13 years on adult hepatitis C virus (HCV) recipients in terms of survival and HCV recurrence is undefined. To determine if adults undergoing liver transplantation for HCV who receive a graft from a donor age less than or equal to 13 years have similar outcomes to recipients of organs from 18- to 35-year-old donors.


METHODS
Records from adult HCV patients undergoing liver transplantation between April 1998 and April 2004 who received whole grafts from non-HCV donors less than 35 years old after brain death were reviewed. Patients with donor age less than or equal to 13 years (group 1) and 18 to 35 years (group 2) were compared for patient and graft survival, allograft rejection, biliary complications, and HCV recurrence.


RESULTS
Fifty-one HCV patients were analyzed. The two groups were similar except that group 1 donors and recipients were smaller in size. One year patient and graft survival for groups 1 vs. 2 were 93% vs. 94% and 93% vs. 83%, respectively (P=NS). Biliary complications, HCV recurrence, and advanced fibrosis free survival were not significantly different.


CONCLUSIONS
Whole liver grafts from donors age less than or equal to 13 years can potentially be used in selected size-matched adult HCV patients in the absence of an acceptable pediatric recipient.
Ghabril
Marwan
M
Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Jacksonville, FL 32224, USA.
Dickson
Rolland C
RC
Krishna
Murli
M
Bonatti
Hugo
H
Aranda-Michel
Jaime
J
Keaveny
Andrew P
AP
Satyanarayana
Raj
R
Hewitt
Winston
W
Hughes
Christopher B
CB
Nguyen
Justin H
JH
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D001926:Brain Death; D002648:Child; D018572:Disease-Free Survival; D005705:Gallbladder Diseases / Q000453:epidemiology; D019698:Hepatitis C, Chronic / Q000601:surgery*; D006801:Humans; D008099:Liver / Q000033:anatomy & histology / Q000254:growth & development; D016031:Liver Transplantation / Q000401:mortality* / Q000706:statistics & numerical data; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D016019:Survival Analysis; D017741:Survivors; D014019:Tissue Donors / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult