Use of liver grafts from donation after cardiac death donors for recipients with hepatitis C virus

C. Burcin Taner, Ilynn G. Bulatao, Andrew P. Keaveny, Darrin L. Willingham, Surakit Pungpapong, Dana K. Perry, Barry G. Rosser, Denise Harnois, Jaime Aranda -Michel, Justin H Nguyen

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Hepatitis C virus (HCV) infection is the most common indication for orthotopic liver transplantation in the United States. Although studies have addressed the use of expanded criteria donor organs in HCV+ patients, to date the use of liver grafts from donation after cardiac death (DCD) donors in HCV+ patients has been addressed by only a limited number of studies. This retrospective analysis was undertaken to study the outcomes of DCD liver grafts used in HCV+ recipients. Seventy-seven HCV+ patients who received DCD liver grafts were compared to 77 matched HCV + patients who received donation after brain death (DBD) liver grafts and 77 unmatched non-HCV patients who received DCD liver grafts. There were no differences in 1-, 3-, and 5-year patient or graft survival among the groups. Multivariate analysis showed that the Model for End-Stage Liver Disease score [hazard ratio (HR) = 1.037, 95% confidence interval (CI) = 1.006-1.069, P = 0.018] and posttransplant cytomegalovirus infection (HR = 3.367, 95% CI = 1.493-7.593, P = 0.003) were significant factors for graft loss. A comparison of the HCV+ groups for fibrosis progression based on protocol biopsy samples up to 5 years post-transplant did not show any difference; in multivariate analysis, HCV genotype 1 was the only factor that affected progression to stage 2 fibrosis (genotype 1 versus non-1 genotypes: HR = 2.739, 95% CI = 1.047-7.143, P = 0.040). In conclusion, this match-controlled, retrospective analysis demonstrates that DCD liver graft utilization does not cause untoward effects on disease progression or patient and graft survival in comparison with DBD liver grafts in HCV+ patients. Liver Transpl 17:641-649, 2011.

Original languageEnglish (US)
Pages (from-to)641-649
Number of pages9
JournalLiver Transplantation
Volume17
Issue number6
DOIs
StatePublished - Jun 2011

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Hepacivirus
Tissue Donors
Transplants
Liver
Brain Death
Genotype
Graft Survival
Confidence Intervals
Fibrosis
Multivariate Analysis
End Stage Liver Disease
Cytomegalovirus Infections
Virus Diseases
Liver Transplantation
Disease Progression
Outcome Assessment (Health Care)
Viruses
Biopsy

ASJC Scopus subject areas

  • Surgery
  • Transplantation
  • Hepatology

Cite this

Use of liver grafts from donation after cardiac death donors for recipients with hepatitis C virus. / Taner, C. Burcin; Bulatao, Ilynn G.; Keaveny, Andrew P.; Willingham, Darrin L.; Pungpapong, Surakit; Perry, Dana K.; Rosser, Barry G.; Harnois, Denise; Aranda -Michel, Jaime; Nguyen, Justin H.

In: Liver Transplantation, Vol. 17, No. 6, 06.2011, p. 641-649.

Research output: Contribution to journalArticle

Taner, CB, Bulatao, IG, Keaveny, AP, Willingham, DL, Pungpapong, S, Perry, DK, Rosser, BG, Harnois, D, Aranda -Michel, J & Nguyen, JH 2011, 'Use of liver grafts from donation after cardiac death donors for recipients with hepatitis C virus', Liver Transplantation, vol. 17, no. 6, pp. 641-649. https://doi.org/10.1002/lt.22258
Taner, C. Burcin ; Bulatao, Ilynn G. ; Keaveny, Andrew P. ; Willingham, Darrin L. ; Pungpapong, Surakit ; Perry, Dana K. ; Rosser, Barry G. ; Harnois, Denise ; Aranda -Michel, Jaime ; Nguyen, Justin H. / Use of liver grafts from donation after cardiac death donors for recipients with hepatitis C virus. In: Liver Transplantation. 2011 ; Vol. 17, No. 6. pp. 641-649.
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abstract = "Hepatitis C virus (HCV) infection is the most common indication for orthotopic liver transplantation in the United States. Although studies have addressed the use of expanded criteria donor organs in HCV+ patients, to date the use of liver grafts from donation after cardiac death (DCD) donors in HCV+ patients has been addressed by only a limited number of studies. This retrospective analysis was undertaken to study the outcomes of DCD liver grafts used in HCV+ recipients. Seventy-seven HCV+ patients who received DCD liver grafts were compared to 77 matched HCV + patients who received donation after brain death (DBD) liver grafts and 77 unmatched non-HCV patients who received DCD liver grafts. There were no differences in 1-, 3-, and 5-year patient or graft survival among the groups. Multivariate analysis showed that the Model for End-Stage Liver Disease score [hazard ratio (HR) = 1.037, 95{\%} confidence interval (CI) = 1.006-1.069, P = 0.018] and posttransplant cytomegalovirus infection (HR = 3.367, 95{\%} CI = 1.493-7.593, P = 0.003) were significant factors for graft loss. A comparison of the HCV+ groups for fibrosis progression based on protocol biopsy samples up to 5 years post-transplant did not show any difference; in multivariate analysis, HCV genotype 1 was the only factor that affected progression to stage 2 fibrosis (genotype 1 versus non-1 genotypes: HR = 2.739, 95{\%} CI = 1.047-7.143, P = 0.040). In conclusion, this match-controlled, retrospective analysis demonstrates that DCD liver graft utilization does not cause untoward effects on disease progression or patient and graft survival in comparison with DBD liver grafts in HCV+ patients. Liver Transpl 17:641-649, 2011.",
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