title: Comparative analysis of hepatitis C recurrence and fibrosis progression between deceased-donor and living-donor liver transplantation: 8-year longitudinal follow-up.
abstract: BACKGROUND
  Hepatitis C virus (HCV) recurrence is universal after liver transplantation (LT). Whether the progression of recurrent HCV is faster after live-donor LT (LDLT) compared with deceased-donor LT (DDLT) is debatable.
  
  
  RESULTS
  We retrospectively examined 100 consecutive LTs (65 DDLTs and 35 LDLTs) performed between July 2000 and July 2003. A total of 147 liver biopsies were performed between 6 months post-LT and last follow-up. Mean donor age and model for end-stage liver disease (MELD) score were significantly lower in LDLT (P<0.01). On a mean follow-up of 86.6±6.8 months, overall patient and graft survivals were 61% (51% DDLT vs. 77.1% LDLT; P=0.026) and 56% (46.2% DDLT vs. 71.4% LDLT; P=0.042), respectively. Eight of 39 (20.5%) deaths (7 DDLT and 1 LDLT) and two of nine (22.2%) retransplants (one in each group) were related to recurrent HCV. Mean fibrosis scores for DDLT and LDLT were 1.9±1.7 and 1.6±1.4, respectively (P=0.01). When donor age less than 50 years and MELD score less than 25 were matched among 64 patients (32 DDLT and 32 LDLT), the overall patient and graft survivals were 73.4% (68.8% DDLT vs. 78.1% LDLT; P=0.439) and 71.9% (71.9% DDLT vs. 71.9% LDLT; P=0.978), respectively.
  
  
  CONCLUSIONS
  Long-term survival rates were better, and fibrosis scores were lower for LDLT. The survivals between LDLT and DDLT were comparable for patients with MELD score less than 25 and donor age less than 50 years.
authors.affiliation: Division of Abdominal Organ Transplantation, Department of Surgery, Temple University Hospital, Philadelphia, PA 19140, USA. ashokkumar.jain@tuhs.temple.edu
authors.forename: Ashokkumar
authors.initials: A
authors.lastname: Jain
authors.forename: Ashish
authors.initials: A
authors.lastname: Singhal
authors.forename: Randeep
authors.initials: R
authors.lastname: Kashyap
authors.forename: Saman
authors.initials: S
authors.lastname: Safadjou
authors.forename: Charlotte K
authors.initials: CK
authors.lastname: Ryan
authors.forename: Mark S
authors.initials: MS
authors.lastname: Orloff
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D002102:Cadaver; D018450:Disease Progression; D058625:End Stage Liver Disease / Q000209:etiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods / Q000401:mortality / Q000473:pathology; D019520:Living Donors; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D014019:Tissue Donors
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents