Post-transplant outcomes of patients with and without hepatitis C virus infection according to donor age and gender matching
Michał Grąt, Oskar Kornasiewicz, Zbigniew Lewandowski, Joanna Ligocka, Karolina Grąt, Karolina Maria Wronka, Krzysztof Zieniewicz, Marek Krawczyk
Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
Ann Transplant 2013; 18:705-715
Available online: 2013-12-23
The purpose of this study was to evaluate the impact of donor age and donor-recipient gender matching on liver transplantation outcomes, focusing on differences between patients with and without hepatitis C virus (HCV) infection.
Material and Methods: This retrospective cohort study evaluated 622 liver transplantation recipients. HCV (n=164) and non-HCV (n=458) patients were subdivided by donor age (≤30, 31–50, and >50 years) and donor-recipient gender configurations. Five-year patient survival (PS) and graft survival (GS) were set as outcome measures.
Results: Five-year PS was 83.1% for HCV-positive and 81.6% for HCV-negative patients (p=0.614), with the corresponding GS rates of 81.2% and 79.3% (p=0.538), respectively. In HCV patients, transplantations from donors older than 50 years were associated with lower PS (p=0.035) and GS (p=0.006) than those from donors aged 31–50 years. This difference was not observed among non-HCV recipients (PS, p=0.994; GS, p=0.878). Regarding donor-recipient gender configurations, outcomes were similar in HCV (PS, p=0.751; GS, p=0.592) and non-HCV patients (PS, p=0.217; GS, p=0.249), except for a tendency toward lower PS for male-to-female transplantations than female-to-female transplantations in non-HCV patients (p=0.064). Outcomes of HCV patients were superior to those of non-HCV patients after transplantation from donors aged 31–50 years (PS, p=0.080; GS, p=0.026).
Conclusions: Avoiding the transplantation of grafts from donors aged over 50 years to patients with HCV infection might improve the general outcomes of liver transplantation programs. There is no specific rationale for gender matching with respect to HCV status.
Keywords: donor gender, Donor Age, gender matching, outcomes, hepatitis C virus, Liver Transplantation