Transplantation of hepatitis C-positive livers in hepatitis C-positive patients is equivalent to transplanting hepatitis C-negative livers

A significant number of patients with end-stage liver disease secondary to hepatitis C die of disease-related complications. Liver transplantation off ers the only effective alternative. Unfortunately, organ demand exceeds sup ply. Consequently, some transplant centers have used hepatitis C virus-posi tive (HCV+) donor livers for HCV+ recipients. This study reviews the clinic al outcome of a large series of HCV+ recipients of HCV+ liver allografts an d compares their course with that of HCV+ recipients of HCV-negative (HCV-) allografts. The United Network for Organ Sharing Scientific Registry was r eviewed for the period from April 1, 1994, to June 30, 1997. All HCV+ trans plant recipients were analyzed. Two groups were identified: a group of HCV recipients of HCV+ donor livers (n = 96), and a group of HCV+ recipients o f HCV- donor livers (n = 2,827). A multivariate logistic regression model w as used to determine the odds of graft failure and patient mortality, and u nadjusted graft and patient survival were determined using the Kaplan-Meier method. There were no differences in demographic criteria between the grou ps. A greater percentage of patients with hepatocellular carcinoma received an HCV+ allograft (8.3% v 3.1%, P = .01). Patient survival showed a signif icant difference for the HCV+ group compared with the HCV- group (90% v 77% ; P = .01). Blood type group A, group B, group O incompatibility was signif icant, with 4.2% incompatibility in the HCV+ group and only 1.3% in the HCV - group (P = .04). Donor hepatitis C status does not impact on graft or pat ient survival after liver transplantation for HCV+ recipients. Their surviv al was equivalent, if not better, compared with the control group. Using HC V+ donor livers for transplantation in HCV+ recipients safely and effective ly expands the organ donor pool.