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Updated: Aug 27, 2025
A Protocol for Analyzing Hepatitis C Virus Replication
Published on: June 26, 2014
Analysis of hepatitis C virus-positive organs in liver transplantation
1Department of Legal and Forensic Medicine, Biomedical Research Institute, Regional Campus of International Excellence "Campus Mare Nostrum", Faculty of Medicine, University of Murcia, Murcia 30100, Spain. isalegaz@um.es.
Insights
Hepatitis C virus (HCV)-positive donor liver transplants offer survival rates comparable to HCV-negative transplants. Direct-acting antiviral therapies have made using HCV-positive donor organs a viable option.
Area of Science:
- Hepatology
- Transplantation Medicine
- Infectious Diseases
Background:
- Hepatitis C virus (HCV) infection remains a significant concern in liver transplantation (LT).
- Direct-acting antiviral (DAA) therapies demonstrate high efficacy (nearly 100%) in treating HCV.
- Historically, there has been reluctance to utilize HCV-positive donor organs in HCV-negative recipients due to clinical and ethical considerations.
Purpose of the Study:
- To evaluate the outcomes of liver transplantation using HCV-positive donor organs.
- To compare survival rates between recipients of HCV-positive donor organs and those receiving HCV-negative donor organs.
- To assess the impact of DAA therapies on the utilization and outcomes of HCV-positive donor livers.
Main Methods:
- Retrospective analysis of liver transplant data from April 1, 2014.
- Inclusion criteria: donor and recipient aged ≥18 years and positive HCV status.
- Analysis focused on the first transplant per recipient to ensure data integrity.
Main Results:
- Survival rates for HCV-positive donor/HCV-negative recipient pairs are comparable to HCV-negative donor/HCV-negative recipient pairs.
- The study period (2006-2016) saw a decrease in HCV-positive patients on waiting lists and LT recipients.
- HCV-positive donors primarily benefited HCV-positive recipients or those with fulminant hepatic failure.
Conclusions:
- The comparable survival rates underscore the effectiveness of DAA regimens in managing HCV post-transplantation.
- Increased utilization of HCV-positive donor organs is supported by evidence of similar outcomes.
- Further research may address remaining clinical and ethical considerations regarding HCV-positive donor organ use.
Abstract:
The authors of this study note that in liver transplantation (LT), the survival rates of hepatitis C virus (HCV)-positive donors and HCV-negative receivers are comparable to those of HCV-negative donors and recipients. Direct-acting antiviral (DAA) therapies have nearly 100% effectiveness in treating HCV. Between 2006 and 2016, the percentages of HCV-positive patients on the waiting list and HCV-positive LT recipients fell by 8.2 percent and 7.6 percent, respectively. Records from April 1, 2014, in which the donor and receiver were both at least 18 years old and had a positive HCV status, were the only ones eligible for the study. The analysis for this study was restricted to the first transplant recorded for each patient using a data element that documented the number of prior transplants for each recipient, although some recipients appeared multiple times in the data set. HCV-positive recipients or people with fulminant hepatic failure were the main beneficiaries of primary biliary cirrhosis among HCV-positive donors. However, there is still a reticence to use HCV-positive donor organs in HCV recipients due to clinical and ethical considerations. Similar survival rates between HCV-positive donors and recipients and HCV-negative donors and receivers illustrate the efficacy of these DAA regimens.
