title: Liver Retransplantation for Recurrence of HCV-Related Cirrhosis Using Hepatitis C-Positive Allografts: A 19-Year OPTN Analysis.
abstract: BACKGROUND Liver re-transplantation (re-OLT) in hepatitis C-infected (HCV+) recipients remains a controversial life-saving procedure, as the process of allograft HCV reinfection is universal. Current literature and practice show that in primary liver transplantations (OLT) in HCV+ recipients, HCV+ grafts have equivalent graft survival as non-infected (HCV-) grafts. MATERIAL AND METHODS Standard Transplant Analysis and Research (STAR) files from the OPTN (Organ Procurement and Transplantation Network) were used to identify HCV+ patients who underwent a second transplant between 3/16/1994 and 6/30/2013. Of 33 816 HCV+ patients who underwent primary OLT during this time 2345 underwent re-OLT; of whom 2079 could be confirmed as second transplants. Out of 2079 HCV+ patients who underwent retransplantation, 75 received HCV+ grafts and 2004 received HCV- grafts. Excluding primary or secondary graft losses within 1 week of transplant, 60 HCV+ donor grafts and 1557 HCV- donor grafts at re-transplantation remained for more focused analysis. RESULTS Graft survival for these patients appeared essentially identical regardless of whether they received an HCV+ or HCV- graft. In addition, using the 33 816 HCV+ patients who underwent primary transplantation during this time, our data agreed with the results of previous studies showing that HCV+ patients who receive HCV+ grafts at first transplant have equivalent graft and patient survival rates. CONCLUSIONS Due to the equivalency of HCV graft survival in re-OLT, selecting HCV+ donor organs for hepatitis C-infected recipients appears to be appropriate.
authors.affiliation: Department of Surgery, Division of Transplantation, Sidney Kimmel Medical College, Thomas Jefferson University Hospitals, Philadelphia, PA, USA.
authors.forename: Justin C
authors.initials: JC
authors.lastname: Torosian
authors.affiliation: Department of Statistics, Sidney Kimmel Medical College, Thomas Jefferson University Hospitals, Philadelphia, PA, USA.
authors.forename: Benjamin E
authors.initials: BE
authors.lastname: Leiby
authors.affiliation: Department of Medicine, Sidney Kimmel Medical College, Thomas Jefferson University Hospitals, Philadelphia, PA, USA.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Fenkel
authors.affiliation: Department of Surgery, Division of Transplantation, Sidney Kimmel Medical College, Thomas Jefferson University Hospitals, Philadelphia, PA, USA.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Frank
authors.affiliation: Department of Surgery, Division of Transplantation, Sidney Kimmel Medical College, Thomas Jefferson University Hospitals, Philadelphia, PA, USA.
authors.forename: Carlo G
authors.initials: CG
authors.lastname: Ramirez
authors.affiliation: Department of Surgery, Division of Transplantation, Sidney Kimmel Medical College, Thomas Jefferson University Hospitals, Philadelphia, PA, USA.
authors.forename: Cataldo
authors.initials: C
authors.lastname: Doria
mesh_terms: D000328:Adult; D064591:Allografts; D015331:Cohort Studies; D046148:Donor Selection; D005260:Female; D006085:Graft Survival; D019698:Hepatitis C, Chronic / Q000150:complications / Q000601:surgery*; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D014019:Tissue Donors; D009927:Tissue and Organ Procurement; D055815:Young Adult