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Liver transplantation from anti-hepatitis C virus-positive donors: our experience
E Álvaro1, M Abradelo, A Fuertes
1Department of General and Digestive Surgery, Hospital Universitario 12 de Octubre. eac.lomba@gmail.com
Insights
Hepatitis C virus (HCV)-positive donor livers are safe for transplant in HCV-positive recipients, showing no difference in survival rates. Many donors with positive HCV antibodies had undetectable viral loads, making them viable options.
Area of Science:
- Hepatology
- Transplant Surgery
- Virology
Background:
- Hepatitis C virus (HCV) is a leading cause of end-stage liver disease globally.
- Organ donor shortages necessitate exploring alternative sources, including HCV-positive donors.
- HCV recurrence is common in HCV-positive liver transplant recipients, requiring careful evaluation of outcomes.
Purpose of the Study:
- To evaluate the safety and efficacy of using Hepatitis C virus (HCV)-positive donor livers for liver transplantation in HCV-positive recipients.
- To compare patient and graft survival rates between recipients of HCV-positive and HCV-negative donor livers.
- To analyze the recurrence, timing, and severity of hepatitis in recipients based on donor HCV status.
Main Methods:
- A retrospective analysis of 143 liver transplants (OLT) performed between January 2005 and April 2011 for HCV-related end-stage liver disease.
- A cohort of 13 patients received organs from HCV-positive donors, compared to 130 recipients of HCV-negative donor organs.
- Donor HCV status was determined by antibody testing and viral load quantification; patient/graft survival and hepatitis recurrence were analyzed.
Main Results:
- Of 143 transplants, 9.1% involved HCV-positive donors; 72.7% of these donors had a negative viral load.
- Patient and graft survival rates showed no significant difference between the groups receiving organs from HCV-positive versus HCV-negative donors.
- Hepatitis recurrence occurred in 80% of recipients, with 22.4% experiencing severe cases, irrespective of donor HCV status.
Conclusions:
- Liver grafts from HCV-positive donors are a safe and effective option for HCV-positive recipients, especially when the donor has a negative viral load.
- The study demonstrates comparable survival outcomes, challenging the notion of universal disease recurrence impacting graft viability.
- Utilizing HCV-positive donor organs can help alleviate donor shortages without compromising transplant success rates.
Background:
Hepatitis C (HCV) is among the most common causes of end-stage liver disease worldwide. The donor shortage leads us to consider alternative organ sources such as HCV-positive donors. The outcomes of these transplants must be evaluated thoroughly since there is universal recurrence of disease among HCV-positive liver transplant recipients.
Methods:
From January 2005 to April 2011, we performed 143 liver transplants (OLT) to treat end-stage liver disease secondary to HCV infection. Thirteen patients (9,1%) received livers from HCV-positive donors. A control group consisted of 130 HCV-positive patients who underwent OLT during the same period with organs from HCV-negative donors. Donor HCV status was assessed by 2 tests: HCV antibodies and viral load. Not only recipient and graft survivals were analyzed, but also frequency, timing and severity of hepatitis recurrence.
Results:
Among 143 transplants performed in HCV-positive recipients during a 6-year period from January 1, 2005, to April 30, 2011, 9.1% of patients received an organ from an anti-HCV-positive donor, 72.7% of whom showed a negative viral load. The vast majority (80%) of our patients suffered hepatitis during their follow-up, 22.4% of which were severe cases.
Conclusions:
No significant difference in patient or graft survival was observed between the 2 groups. A high percentage of grafts with initial positive serology for HCV showed no viral replication. Grafts from HCV-positive donors can be considered to be a safe, effective source for liver donation.
