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Use of Hepatitis C-Positive Liver Grafts in Hepatitis C-Negative Recipients

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Abstract

As the demand for liver transplantation continues to rise, the scarcity of liver donor grafts has led to the use of extended criteria grafts for liver transplantation in select group of patients. Hepatitis C-seropositive liver grafts have been used primarily in hepatitis C-positive recipients, with studies showing non-inferior outcomes when compared to hepatitis C-negative grafts. Studies suggest that hepatitis C serology status of the donor liver does not influence the patient or graft outcomes in the recipient. These results advocate for offering hepatitis C-positive grafts to all patients awaiting liver transplantation regardless of their hepatitis C status. However, some concerns persist regarding the ethics of potentially introducing a new infection into a patient that could progress to chronic liver disease following liver transplantation. The recent approval of direct-acting antiviral therapy offers a solution to this dilemma, as it has changed the landscape of hepatitis C management by making it a curable disease. In this review, we shall discuss the current evidence regarding the use of hepatitis C-seropositive donor grafts in hepatitis C-positive and hepatitis C-negative patients.

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Authors and Affiliations

  1. Departments of Medicine, University of California at Los Angeles, Los Angeles, CA, USA

    Akshay Shetty & Sammy Saab

  2. Departments of Surgery, University of California at Los Angeles, Los Angeles, CA, USA

    Adam Buch & Sammy Saab

  3. Pfleger Liver Institute, UCLA Medical Center, 200 Medical Plaza, Suite 214, Los Angeles, CA, 90095, USA

    Sammy Saab

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  1. Akshay Shetty
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  2. Adam Buch
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  3. Sammy Saab
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Role in the Study: Study concept and design (AS, SS); acquisition of data (AS, AB); analysis and interpretation of data (AS, AB); drafting of the manuscript (AS, SS); critical revision of the manuscript for important intellectual content (AS, SS); statistical analysis (AS, SS, AB); obtained funding (not applicable); administrative, technical, or material support (SS); study supervision (SS).

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Correspondence to Sammy Saab.

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Shetty, A., Buch, A. & Saab, S. Use of Hepatitis C-Positive Liver Grafts in Hepatitis C-Negative Recipients. Dig Dis Sci 64, 1110–1118 (2019). https://doi.org/10.1007/s10620-018-5404-x

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