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03 May 2016 : Original article  

Liver Retransplantation for Recurrence of HCV-Related Cirrhosis Using Hepatitis C-Positive Allografts: A 19-Year OPTN Analysis

Justin C. TorosianBCDEF, Benjamin E. LeibyCD, Jonathan M. FenkelDEF, Adam M. FrankCDE, Carlo G. RamirezDE, Cataldo DoriaADEF

DOI: 10.12659/AOT.897040

Ann Transplant 2016; 21:262-269

Abstract

BACKGROUND: Liver re-transplantation (re-OLT) in hepatitis C-infected (HCV+) recipients remains a controversial life-saving procedure, as the process of allograft HCV reinfection is universal. Current literature and practice show that in primary liver transplantations (OLT) in HCV+ recipients, HCV+ grafts have equivalent graft survival as non-infected (HCV–) grafts.

MATERIAL AND METHODS: Standard Transplant Analysis and Research (STAR) files from the OPTN (Organ Procurement and Transplantation Network) were used to identify HCV+ patients who underwent a second transplant between 3/16/1994 and 6/30/2013. Of 33 816 HCV+ patients who underwent primary OLT during this time 2345 underwent re-OLT; of whom 2079 could be confirmed as second transplants. Out of 2079 HCV+ patients who underwent retransplantation, 75 received HCV+ grafts and 2004 received HCV– grafts. Excluding primary or secondary graft losses within 1 week of transplant, 60 HCV+ donor grafts and 1557 HCV– donor grafts at re-transplantation remained for more focused analysis.

RESULTS: Graft survival for these patients appeared essentially identical regardless of whether they received an HCV+ or HCV– graft. In addition, using the 33 816 HCV+ patients who underwent primary transplantation during this time, our data agreed with the results of previous studies showing that HCV+ patients who receive HCV+ grafts at first transplant have equivalent graft and patient survival rates.

CONCLUSIONS: Due to the equivalency of HCV graft survival in re-OLT, selecting HCV+ donor organs for hepatitis C-infected recipients appears to be appropriate.

Keywords: Hepatitis C Antibodies, Liver, Transplantation

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358