Increased risk of severe recurrence of hepatitis c virus in liver transplant recipients of donation after cardiac death allografts

Roberto Hernandez-Alejandro, Kris P. Croome, Douglas Quan, Mohamed Mawardi, Natasha Chandok, Cheryl Dale, Vivian McAlister, Mark A. Levstik, William Wall, Paul Marotta

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

Background. In hepatitis C virus (HCV) recipients of donation after cardiac death (DCD) grafts, there is suggestion of lower rates of graft survival, indicating that DCD grafts themselves may represent a significant risk factor for severe recurrence of HCV. Methods. We evaluated all DCD liver transplant recipients from August 2006 to February 2011 at our center. Recipients with HCV who received a DCD graft (group 1, HCV+ DCD, n=17) were compared with non-HCV recipients transplanted with a DCD graft (group 2, HCV-DCD, n=15), and with a matched group of HCV recipients transplanted with a donation after brain death (DBD) graft (group 3, HCV+ DBD, n=42). Results. A trend of poorer graft survival was seen in HCV+ patients who underwent a DCD transplant (group 1) compared with HCV-patients who underwent a DCD transplant (group 2) (P=0.14). Importantly, a statistically significant difference in graft survival was seen in HCV+ patients undergoing DCD transplant (group 1) (73%) as compared with DBD transplant (group 3) (93%)(P=0.01). There was a statistically significant increase in HCV recurrence at 3 months (76% vs. 16%) (P=0.005) and severe HCV recurrence within the first year (47% vs. 10%) in the DCD group (P=0.004). Conclusions. HCV recurrence is more severe and progresses more rapidly in HCV+ recipients who receive grafts from DCD compared with those who receive grafts from DBD. DCD liver transplantation in HCV+ recipients is associated with a higher rate of graft failure compared with those who receive grafts from DBD. Caution must be taken when using DCD grafts in HCV+ recipients.

Original languageEnglish (US)
Pages (from-to)686-689
Number of pages4
JournalTransplantation
Volume92
Issue number6
DOIs
StatePublished - Sep 27 2011

Keywords

  • Donation after cardiac death
  • Hepatitis C virus
  • Liver transplant

ASJC Scopus subject areas

  • Transplantation

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    Hernandez-Alejandro, R., Croome, K. P., Quan, D., Mawardi, M., Chandok, N., Dale, C., McAlister, V., Levstik, M. A., Wall, W., & Marotta, P. (2011). Increased risk of severe recurrence of hepatitis c virus in liver transplant recipients of donation after cardiac death allografts. Transplantation, 92(6), 686-689. https://doi.org/10.1097/TP.0b013e31822a79d2