title: Long-term outcomes of liver transplantation in patients with hepatitis C infection are not affected by HCV positivity of a donor.
abstract: BACKGROUND
  The use of HCV-positive livers for HCV-positive recipients is becoming more common. Our aim is to evaluate long-term outcomes in liver transplant recipients transplanted with HCV antibody-positive organs.
  
  
  METHODS
  From the Scientific Registry of Transplant Recipients (1995-2013), we selected all adult liver transplant recipients with HCV, and cross-sectionally compared long-term graft loss and mortality rates between those who were transplanted from HCV antibody-positive (HCV+) vs. HCV antibody-negative donors.
  
  
  RESULTS
  We included 33,668 HCV+ liver transplant recipients (54.0 ± 7.7 years old, 74.1% male, 71.0% white, 23.6% with liver malignancy). Of those, 5.7% (N = 1930) were transplanted from HCV+ donors; the proportion gradually increased from 2.9% in 1995 to 9.4% in 2013. Patients who were transplanted from HCV+ positive donors were more likely to be discharged alive after transplantation (95.4% vs. 93.9%, p = 0.006), but this difference was completely accounted for by a greater proportion of HCV+ donors in more recent study years (p = 0.10 after adjustment for the transplant year). After transplantation, both mortality in HCV patients transplanted from HCV+ donors (12.5% in 1 year, 24.2% in 3 years, 33.0% in 5 years) and the graft loss rate (2.2% in 1 year, 4.8% in 3 years, 7.5% in 5 years) were similar to those in HCV patients transplanted from HCV-negative donors (all p > 0.05).
  
  
  CONCLUSIONS
  Over the past two decades, the use of HCV+ organs for liver transplantation has tripled. Despite this, the long-term outcomes of HCV+ liver transplant recipients transplanted from HCV+ donors were not different from those who were transplanted with HCV-negative organs.
authors.affiliation: Betty and Guy Beatty Center for Integrated Research, Inova Health System, Claude Moore Health Education and Research Building 3300 Gallows Road, Falls Church, VA, 22042, USA.|Center for Outcomes Research in Liver Diseases, Washington, DC, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Stepanova
authors.affiliation: Betty and Guy Beatty Center for Integrated Research, Inova Health System, Claude Moore Health Education and Research Building 3300 Gallows Road, Falls Church, VA, 22042, USA.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sayiner
authors.affiliation: Betty and Guy Beatty Center for Integrated Research, Inova Health System, Claude Moore Health Education and Research Building 3300 Gallows Road, Falls Church, VA, 22042, USA.
authors.forename: Leyla
authors.initials: L
authors.lastname: de Avila
authors.affiliation: Betty and Guy Beatty Center for Integrated Research, Inova Health System, Claude Moore Health Education and Research Building 3300 Gallows Road, Falls Church, VA, 22042, USA.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Younoszai
authors.affiliation: Betty and Guy Beatty Center for Integrated Research, Inova Health System, Claude Moore Health Education and Research Building 3300 Gallows Road, Falls Church, VA, 22042, USA.
authors.forename: Andrei
authors.initials: A
authors.lastname: Racila
authors.affiliation: Betty and Guy Beatty Center for Integrated Research, Inova Health System, Claude Moore Health Education and Research Building 3300 Gallows Road, Falls Church, VA, 22042, USA. zobair.younossi@inova.org.|Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, USA. zobair.younossi@inova.org.
authors.forename: Zobair M
authors.initials: ZM
authors.lastname: Younossi
mesh_terms: D000328:Adult; D046148:Donor Selection; D005260:Female; D006085:Graft Survival; D016174:Hepacivirus; D006526:Hepatitis C / Q000601:surgery* / Q000821:virology; D018937:Hepatitis C Antibodies / Q000032:analysis; D006801:Humans; D008099:Liver / Q000601:surgery / Q000821:virology; D016031:Liver Transplantation / Q000379:methods / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D019737:Transplants / Q000821:virology*; D016896:Treatment Outcome
chemical_list: D018937:Hepatitis C Antibodies
keywords: Extended criteria donor; HCV; Liver transplant