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 M. Harnois, Jaime Aranda -Michel, Justin H. Nguyen

Research output: Contribution to journalArticle

35 Scopus citations

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 1 2011

ASJC Scopus subject areas

  • Surgery
  • Hepatology
  • Transplantation

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    Taner, C. B., Bulatao, I. G., Keaveny, A. P., Willingham, D. L., Pungpapong, S., Perry, D. K., Rosser, B. G., Harnois, D. M., Aranda -Michel, J., & Nguyen, J. H. (2011). Use of liver grafts from donation after cardiac death donors for recipients with hepatitis C virus. Liver Transplantation, 17(6), 641-649. https://doi.org/10.1002/lt.22258