title: Results of live donor liver transplantation in patients with hepatitic C virus infection: the HCV 3 trial experience.
abstract: Chronic hepatitis C virus (HCV) is the most common disease indication for liver transplantation (LT). Outcomes are compromised by near universal recurrence of HCV. A prospective multi-center randomized study to evaluate immunosuppressive strategies in HCV+ transplant recipients provided the opportunity to assess impact of live donor (LD) LT. Two hundred and ninety-five patients undergoing LT for HCV (260 deceased donor [DD] recipients/35 LD recipients), randomized to three regimens, were followed for two yr for patient and graft survival and rate and severity of recurrent HCV. Biopsies were performed at baseline, 3, 12, and 24 months. One- and two-yr patient survival for LD recipients was 88.1% and 81.1% vs. 90.5% and 84.6% for DD recipients (p = 0.5665). One- and two-yr graft survival for LD recipients was 82.9% and 76.2% vs. 87.9% and 81.7% for DD recipients (p = 0.3921). Recurrent HCV did not account for more deaths or graft losses in the LD recipients. In this prospective study, controlled for immunosuppression, use of LD organs did not increase the rate or severity of HCV recurrence. The more elective nature of LDLT affords an opportunity to manipulate donor and recipient factors that can impact upon outcomes.
authors.affiliation: University of Southern California, Los Angeles, CA, USA. lsher@health.usc.edu
authors.forename: Linda
authors.initials: L
authors.lastname: Sher
authors.forename: Linda
authors.initials: L
authors.lastname: Jennings
authors.forename: Steven
authors.initials: S
authors.lastname: Rudich
authors.forename: Sophoclis P
authors.initials: SP
authors.lastname: Alexopoulos
authors.forename: George
authors.initials: G
authors.lastname: Netto
authors.forename: Lewis
authors.initials: L
authors.lastname: Teperman
authors.forename: Milan
authors.initials: M
authors.lastname: Kinkhabwala
authors.forename: Robert S
authors.initials: RS
authors.lastname: Brown
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Pomfret
authors.forename: Goran
authors.initials: G
authors.lastname: Klintmalm
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000401:mortality* / Q000821:virology; D016174:Hepacivirus / Q000254:growth & development*; D019698:Hepatitis C, Chronic / Q000401:mortality* / Q000601:surgery / Q000821:virology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016031:Liver Transplantation / Q000401:mortality*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D015996:Survival Rate; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents