Liver Transplantation from Brain-Dead Donors with Hepatitis B or C in South Korea: A 2014-2020 Korean Organ...

Area of Science:

• Hepatology
• Transplantation immunology
• Infectious diseases

Background:

• Current Korean guidelines restrict liver transplants (LT) from hepatitis B virus (HBV) or hepatitis C virus (HCV) positive donors to only positive recipients.
• This study evaluates the outcomes of LT using brain-dead donors with HBV or HCV in Korea.

Purpose of the Study:

• To determine the current status and outcomes of liver transplantation from brain-dead donors with HBV or HCV in Korea.
• To assess the feasibility of expanding donor criteria in liver transplantation.

Main Methods:

• Retrospective observational study of LTs from brain-dead donors in the Korean Organ Transplantation Registry (April 2014 - December 2020).
• Analysis of donor hepatitis status (HBV(+), HCV(+), HBV(-)/HCV(-)) and recipient outcomes.
• Comparison of Model for End-Stage Liver Disease (MELD) scores and survival rates.

Main Results:

• Five-year graft and patient survival rates for HBV(+) donors were 81.7% and 85.6%, comparable to HBV(-)/HCV(-) donors (76.6% and 76.7%).
• One-year graft and patient survival rates for the single HCV(+) donor graft recipient were 100%.
• MELD scores for HBV(+) donors were significantly lower than for HBV(-)/HCV(-) donors.

Conclusions:

• Liver transplantation outcomes from HBV(+) donors are comparable to those from HBV(-)/HCV(-) donors.
• Current Korean regulations limiting transplants from HBV(+) or HCV(+) donors to only positive recipients should be reconsidered.
• Conditional permission for transplants from HBV(+) or HCV(+) grafts to negative recipients, based on risk-benefit analysis, could expand donor availability and improve patient outcomes.