title: Implications of Treating Hepatitis C Virus Infection Among Patients Awaiting Cadaveric Liver Transplant: A Single-Center Experience.
abstract: OBJECTIVE
  We examined hepatitis C virus positivity among the donors in our center to investigate whether hepatitis C treatment affected liver transplant Model for End-Stage Liver Disease.
  
  
  METHODS
  We retrospectively reviewed all deceased-donor liver transplants performed between January 2013 and December 2014 at our center, with the primary indication of hepatitis C virus. Baseline demographic and laboratory characteristics of recipients and donors were collected. Statistical analyses were done with P values ≤ .05 considered significant.
  
  
  RESULTS
  Seventy-five liver transplants were performed, and 62 of them were hepatitis C virus RNA-positive at the time of liver transplant donor offer. In 2013, during the Pre-Direct Antiviral Agents era, 14 of 33 hepatitis C virus RNA-positive recipients (42%) were matched to hepatitis C virus-positive donors. During the Direct Antiviral Agents era in 2014, this ratio was 38% (11/29) (P = .72). The mean Model for End-Stage Liver Disease at transplant of the 62 hepatitis C virus RNA-positive recipients was 29, whereas the mean Model for End-Stage Liver Disease of 13 hepatitis C virus RNA-negative recipients was 31. This was not statistically significant (P = .25).
  
  
  CONCLUSIONS
  Although hepatitis C virus treatment before liver transplant is an attractive option to eliminate the risk of complications because of recurrent hepatitis C virus after liver transplant, its potential effect on limiting the donor pool for the recipient must also be considered. In our observation, 40% of our donor pool consists of hepatitis C virus-positive donors. Further multiregional studies are warranted to verify this observation and to see the potential effect of direct antiviral agent treatment into waiting times and the Model for End-Stage Liver Disease at organ allocation.
authors.affiliation: From the Johns Hopkins University School of Medicine, Division of Gastroenterology, Baltimore, MD, United States.
authors.forename: Andrew
authors.initials: A
authors.lastname: Ofosu
authors.forename: Christine M
authors.initials: CM
authors.lastname: Durand
authors.forename: Behnam
authors.initials: B
authors.lastname: Saberi
authors.forename: Saleh
authors.initials: S
authors.lastname: Alqahtani
authors.forename: Enver
authors.initials: E
authors.lastname: Ucbilek
authors.forename: Maura
authors.initials: M
authors.lastname: Belden
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Cameron
authors.forename: Ahmet
authors.initials: A
authors.lastname: Gurakar
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D015142:Baltimore; D015415:Biomarkers / Q000097:blood; D046148:Donor Selection; D058625:End Stage Liver Disease / Q000175:diagnosis / Q000601:surgery* / Q000821:virology; D016174:Hepacivirus / Q000187:drug effects* / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome; D014850:Waiting Lists
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D012367:RNA, Viral