Liver Retransplantation for Recurrence of HCV-Related Cirrhosis Using Hepatitis C-Positive Allografts: A 19-Year OPTN Analysis
Justin C. Torosian, Benjamin E. Leiby, Jonathan M. Fenkel, Adam M. Frank, Carlo G. Ramirez, Cataldo Doria
Department of Surgery, Division of Transplantation, Sidney Kimmel Medical College, Thomas Jefferson University Hospitals, Philadelphia, PA, USA
Ann Transplant 2016; 21:262-269
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