title: Long-term follow-up and outcome of liver transplantation from anti-hepatitis C virus-positive donors: a European multicentric case-control study.
abstract: BACKGROUND
  The growing prevalence of hepatitis C virus (HCV) infection in the general population has resulted in an increased frequency of potential organ donors that carry the virus. Given the significant disparity between organ supply and demand for transplantation, it becomes essential to consider whether livers from anti-HCV-positive donors may be considered suitable for transplantation.
  
  
  METHODS
  Based on a multicenter European database, 694 patients with HCV-related cirrhosis underwent liver transplantation and 11% of them received the graft from anti-HCV-positive donors. Of this group, we selected 63 patients (study group) and, after a 1:1 case-control approach, compared them with 63 patients that received an anti-HCV-negative donor graft (control group). Only grafts with preperfusion liver biopsy results with a fibrosis score of not more than 1 were used for transplantation.
  
  
  RESULTS
  Patients who received anti-HCV-positive grafts had a cumulative survival rate of 83.6% and 61.7% at 1 and 5 years, respectively, vs. 95.1% and 68.2% for the control group. In comparing overall patient and graft survival, there was no statistically significant difference between the two groups (P=0.22 and 0.11). Recurrence of hepatitis C tended to be more rapid in the group of patients who received anti-HCV-positive grafts, although it did not reach statistical significance (P=0.07).
  
  
  CONCLUSIONS
  We do not recommend the indiscriminate use of anti-HCV-positive donors, especially if HCV-RNA positive, as the use of this kind of graft could be linked to an advanced stage of fibrosis, the main risk factor we observed for earlier hepatitis C recurrence.
authors.affiliation: Liver and Multivisceral Transplant Center, University of Modena and Reggio Emilia, Modena, Italy. ballarinroberto@hotmail.com
authors.forename: Roberto
authors.initials: R
authors.lastname: Ballarin
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cucchetti
authors.forename: Mario
authors.initials: M
authors.lastname: Spaggiari
authors.forename: Roberto
authors.initials: R
authors.lastname: Montalti
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Di Benedetto
authors.forename: Silvio
authors.initials: S
authors.lastname: Nadalin
authors.forename: Roberto Ivan
authors.initials: RI
authors.lastname: Troisi
authors.forename: Michele
authors.initials: M
authors.lastname: Valmasoni
authors.forename: Cristina
authors.initials: C
authors.lastname: Longo
authors.forename: Nicola
authors.initials: N
authors.lastname: De Ruvo
authors.forename: Nicola
authors.initials: N
authors.lastname: Cautero
authors.forename: Umberto
authors.initials: U
authors.lastname: Cillo
authors.forename: Antonio Daniele
authors.initials: AD
authors.lastname: Pinna
authors.forename: Patrizia
authors.initials: P
authors.lastname: Burra
authors.forename: Giorgio Enrico
authors.initials: GE
authors.lastname: Gerunda
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis; D012008:Recurrence; D015996:Survival Rate; D014019:Tissue Donors; D016896:Treatment Outcome
chemical_list: D018937:Hepatitis C Antibodies; D012367:RNA, Viral