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Is recurrent hepatitis C worse with living donors?

Alexander Kuo1, Norah A Terrault

  • 1Division of Gastroenterology, University of California, San Diego, 200 West Arbor Drive M/C 8413, San Diego, CA 92103, USA. alkuo@ucsd.edu

Current Opinion in Organ Transplantation
|April 28, 2009
PubMed

Insights

Hepatitis C virus (HCV) recurrence after liver transplant is similar for living donor liver transplantation (LDLT) and deceased donor liver transplantation (DDLT). Recent studies show no difference in graft survival or fibrosis progression, supporting LDLT use.

Area of Science:

  • Hepatology
  • Transplantation Immunology
  • Virology

Background:

  • Early studies suggested increased hepatitis C virus (HCV) recurrence severity in living donor liver transplantation (LDLT) recipients versus deceased donor liver transplantation (DDLT).
  • This led to uncertainty regarding the use of live donors for HCV patients.
  • This review addresses the comparative severity of recurrent HCV in LDLT versus DDLT.

Purpose of the Study:

  • To evaluate whether recurrent hepatitis C virus (HCV) infection is more severe in liver transplant recipients who received organs from living donors compared to deceased donors.
  • To clarify the role of living donor liver transplantation (LDLT) in patients with HCV.

Main Methods:

  • Review of recently published studies comparing outcomes of LDLT and DDLT in HCV-positive recipients.
  • Analysis of data on patient and graft survival.
  • Assessment of fibrosis progression using protocol liver biopsies.

Main Results:

  • Recent studies contradict earlier findings of inferior survival in LDLT recipients.
  • The Adult-to-Adult Live Donor Liver Transplant Cohort Study indicated similar patient and graft survival for HCV-positive LDLT and DDLT recipients with experienced centers.
  • No significant difference in fibrosis progression was observed between LDLT and DDLT groups.

Conclusions:

  • Graft survival and fibrosis progression are comparable between LDLT and DDLT recipients up to 5 years post-transplant.
  • Current data support the use of LDLT as a viable additional donor source for liver transplantation in HCV patients.
Abstract

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