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Author Spotlight: Evaluating Therapeutic Strategies to Enhance Liver Regeneration
Published on: May 24, 2024
Increased survival in hepatitis c patients who underwent living donor liver transplant: a case-control study with
Jong Man Kim1, Kwang-Woong Lee2, Gi-Won Song3
1Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Insights
Living donor liver transplantation (LDLT) shows promise for Hepatitis C (HCV) patients, with higher survival rates observed compared to deceased donor liver transplantation (DDLT). Age and tacrolimus use also impact survival.
Area of Science:
- Hepatology
- Transplantation Surgery
- Virology
Background:
- Outcomes of Hepatitis C Virus (HCV) liver transplantation using living donors versus deceased donors remain debated.
- Identifying factors influencing patient survival post-transplant is crucial.
Purpose of the Study:
- To compare patient and donor characteristics between living donor liver transplantation (LDLT) and deceased donor liver transplantation (DDLT) for HCV patients.
- To identify risk factors impacting patient survival after liver transplantation in HCV-positive individuals.
Main Methods:
- Retrospective analysis of multicenter data from 192 HCV RNA-positive patients undergoing liver transplantation.
- Comparison of survival rates between LDLT and DDLT groups, including propensity score matching.
Main Results:
- LDLT group showed higher unadjusted survival rates (86.1% at 1 year, 79.5% at 5 years) compared to DDLT (66.7% at 1 year, 63.0% at 5 years).
- After propensity matching, no statistically significant difference in patient survival was observed between LDLT and DDLT (P=0.061).
- Recipient age ≥ 60 years, LDLT, and tacrolimus use were associated with improved patient survival.
Conclusions:
- LDLT is a viable option for HCV-infected patients when a suitable living donor is available.
- Recipient age and immunosuppression choice (tacrolimus) are important factors for survival post-liver transplantation.
Purpose:
There is no consensus regarding the difference in outcomes of HCV in patients who receive living donor liver transplantation (LDLT) or compared to deceased donor liver transplantation (DDLT). The aims of this study were to compare characteristics between LDLT and DDLT groups and to identify risk factors affecting patient survival.
Methods:
We retrospectively reviewed the multicenter records of 192 HCV RNA-positive patients who underwent liver transplantation.
Results:
Thirty-five patients underwent DDLT, and 146 underwent LDLT. The 1-, 3-, and 5-year patient survival rates were 66.7%, 63.0%, and 63.0% in the DDLT group and 86.1%, 82.3%, and 79.5% in the LDLT group (P = 0.024), respectively. After propensity matching, the patient survival curve of the LDLT group was higher than that of the DDLT group. However, there was no statistically significant difference in patient survival between the 2 groups (P = 0.061). Recipient age ≥ 60 years, LDLT, and use of tacrolimus were positively associated with patient survival in multivariate analyses.
Conclusion:
LDLT appears to be suitable for HCV-infected patients if appropriate living donor is available.
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