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Transplantation 1998 Apr 15;65(7):925-929
Long-term outcome of patients transplanted with livers from hepatitis
C-positive donors.
Testa G, Goldstein RM, Netto G, Abbasoglu O, Brooks BK, Levy MF, Husberg
BS, Gonwa TA, Klintmalm GB
Transplantation Services, Baylor University Medical Center, Dallas, Texas 75246,
USA.
BACKGROUND:
The use of hepatitis C serology-positive donors has become an option in patients
affected by hepatitis C (Hep C) end-stage liver disease. Previous studies with
less than 1 year of follow-up have suggested that there is no difference in
early patient and graft survival. The aim of our review is to confirm with a
longer follow-up (a minimum of 1 year) that the use of these organs is safe
and that patient and graft survival are comparable to those of patients with
Hep C who received Hep C-negative grafts.
METHODS:
Between 1985 and 1995, 213 patients were transplanted with a diagnosis of Hep
C. Seventy-six patients were excluded from the study, 47 for insufficient follow-up
and 29 because the diagnosis of recurrence was not certain. Twenty-two patients
received Hep C+ donor grafts and 115 patients received Hep C-donor grafts. These
two groups were evaluated to assess the rate and severity of recurrence by serial
biopsies and to assess patient and graft survival.
RESULTS:
Recurrent Hep C was documented by biopsy in 12 of 22 patients who received
Hep C+ donor grafts. Of these 12 patients, 9 had mild chronic hepatitis, 2 had
fibrosis, and 1 had cirrhosis. Ten of the 22 patients had normal biopsies. Of
the patients who received Hep C- grafts, 48 of 115 had recurrent disease. Of
these 48 patients, 23 had mild chronic hepatitis, 15 had fibrosis, and 10 had
cirrhosis. Sixty-seven of 115 had normal biopsies. The recurrence rate was 54.55%
in the Hep C+ donor grafts and 41.74% in the Hep C- donor grafts (P=NS). Patient
and graft survival at 4 years after transplant were 83.9% and 71.9% in the Hep
C+ donor grafts and 79.1% and 76.2% in the Hep C- donor grafts, respectively
(P=NS).
CONCLUSIONS:
Our study suggests that Hep C+ donors can be used with excellent long-term
results and that the progression of the recurrent disease does not seem to be
affected by the pre-existence of the Hep C virus in the donor.
PMID: 9565096, UI: 98224768
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