Living donor liver transplantation and hepatitis C

Preliminary results indicate that living donor liver transplantation patients infected with hepatitis C virus (HCV) develop earlier and more severe recurrence than their cadaveric counterparts. The mechanisms underlying this observation are unknown, but could include hepatic regeneration, differences in living donor liver transplantation recipient demographics, immune homology between donor and recipients, or other factors not previously considered. The optimum clinical approach is to only consider living donor liver transplantation in HCV-infected recipients as a life-saving procedure and to attempt to eradicate HCV before transplantation to prevent recurrent infection.