title: Outcomes of living donor liver transplantation for hepatitis C virus-positive recipients in Japan: results of a nationwide survey.
abstract: A nationwide survey of living donor liver transplantation (LDLT) for hepatitis C virus (HCV)-positive recipients was performed in Japan. A total of 514 recipients are reported and included in the study. The cumulative patient survival rate at 5 and 10 years was 72% and 63%, respectively. Of the 514 recipients, 142 patients (28%) died until the end of the observation, among which the leading cause was recurrent hepatitis C (42 cases). According to Cox regression multivariate analysis, donor age (>40), non-right liver graft, acute rejection episode, and absence of a sustained virologic response were independent prognostic factors. Of the 514 recipients, 361 underwent antiviral treatment mainly with pegylated-interferon and ribavirin (preemptive treatment in 150 patients and treatment for confirmed recurrent hepatitis in 211). The dose reduction rate and discontinuation rate were 40% and 42%, respectively, with a sustained virologic response rate of 43%. In conclusion, patient survival of HCV-positive recipients after LDLT was good, with a 10-year survival of 63%. Right liver graft might be preferable for HCV-positive recipients in an LDLT setting.
authors.affiliation: Division of Artificial Organ and Transplantation, Department of Surgery, University of Tokyo, Tokyo, Japan.
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Akamatsu
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kokudo
authors.forename: Susumu
authors.initials: S
authors.lastname: Eguchi
authors.forename: Toshiyoshi
authors.initials: T
authors.lastname: Fujiwara
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohdan
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
authors.forename: Akinobu
authors.initials: A
authors.lastname: Taketomi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Shimada
authors.forename: Yonson
authors.initials: Y
authors.lastname: Ku
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
authors.forename: Toru
authors.initials: T
authors.lastname: Ikegami
authors.forename: Masashi
authors.initials: M
authors.lastname: Mizokami
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate
keywords: hepatitis C virus; living donor liver transplantation; nationwide survey