title: Impact of donor histology on survival following liver transplantation for chronic hepatitis C virus infection: a Scandinavian single-center experience.
abstract: OBJECTIVE
  Survival following liver transplantation for hepatitis C virus (HCV) infection is affected by several factors. The aims of this single-center study were to evaluate survival from 1992 to 2006 in HCV-infected liver transplant recipients and to identify factors influencing patient and graft survival, with particular focus on donor liver histopathology.
  
  
  METHODS
  Survival among 84 patients transplanted for HCV-related liver disease at the Sahlgrenska University Hospital during the above period was evaluated. Median follow-up time was 57 months (range 28-87). A perioperative liver biopsy from the donor liver graft was available in 68 cases. Biopsies were assessed for fibrosis, necroinflammatory activity, and degree of steatosis. Patient and graft survival according to relevant factors including donor histopathology were analyzed by Kaplan-Meier analysis.
  
  
  RESULTS
  We found an association between donor liver fibrosis and patient survival (p = 0.016) as well as between graft survival and portal inflammation in the donor liver (p = 0.026). Both these associations remained significant in multivariate analysis (p = 0.007 and 0.017 respectively). Moreover, recipient age over 60 was found predictive of patient survival and repeated steroid boluses or steroid-resistant rejection of graft survival. Donor age was high throughout the study period.
  
  
  CONCLUSIONS
  Histopathological features, especially portal inflammation and stage of fibrosis, in the donor liver may deleteriously affect graft and patient survival following HCV-related liver transplantation. Thus, pretransplant evaluation of donor histopathology may be of value in the selection of donors for transplantation of HCV-positive individuals, especially among donors older than 60 years.
authors.affiliation: Department of Infectious Diseases/Clinical Virology, Institute of Biomedicine, University of Gothenburg, Sweden. magdalena.ydreborg@gu.se
authors.forename: Magdalena
authors.initials: M
authors.lastname: Ydreborg
authors.forename: Johan
authors.initials: J
authors.lastname: Westin
authors.forename: Martin
authors.initials: M
authors.lastname: Lagging
authors.forename: Maria
authors.initials: M
authors.lastname: Castedal
authors.forename: Styrbjörn
authors.initials: S
authors.lastname: Friman
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D019698:Hepatitis C, Chronic / Q000401:mortality / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008099:Liver / Q000473:pathology*; D016031:Liver Transplantation / Q000276:immunology / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012086:Reoperation / Q000706:statistics & numerical data; D013548:Sweden; D014019:Tissue Donors; D016896:Treatment Outcome