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Survival After Liver Transplantation Using Hepatitis C Virus-Positive Donor Allografts: Case-Controlled Analysis of the UNOS Database

World Journal of Surgery volume 35, pages 1590–1595 (2011)Cite this article

Abstract

Background

Numerous reports have documented reduced graft and patient survival after use of hepatitis C (HCV) seropositive allografts in liver transplantation (OLT). We aimed to examine if the use of a HCV+ liver allograft affects patient and graft survivals compared to HCV− donor allografts in a case-controlled analysis of the united network for organ sharing (UNOS) database.

Methods

We examined 63,149 liver transplants (61,905 donors HCV−; 1,244 donors HCV+) from the UNOS standard transplant analysis and research (STAR) file from 1987 to 2007. Donor and recipient demographics and outcomes were collected in which donor HCV serology was complete. A case-controlled cohort from 11 donor and recipient variables comparing donor HCV− and HCV+ allografts (n = 540 in each group) was created using propensity scores with a matching algorithm. Graft and patient survival was estimated using Kaplan–Meier survival curves.

Results

Significant differences were evident in the unadjusted cohort between recipients who received HCV+ and HCV− allografts, including HCV+ recipients, donor and recipient age, and model for end-stage liver disease (MELD) exception cases. Use of HCV+ allograft resulted in significantly lower graft survival (8.1 vs. 10.6 years; P = 0.001) and patient survival (10.2 vs. 12.3 years; P = 0.01) after OLT. In the matched cohort, HCV seropositivity had no detrimental effect on the graft (P = 0.57) or patient (P = 0.78) survival after OLT.

Conclusions

This is the first population-based analysis to show that after adjusting for donor and recipient characteristics there was no difference in graft or patient survival with the use of HCV+ donor liver allografts compared to HCV− donor liver allografts.

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Acknowledgment

This study was supported by an award from the American Society of Transplant Surgeons Faculty Development (SAS).

Conflict of Interest

The authors have no disclosures to report, and no conflicts of interest exist.

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Authors and Affiliations

  1. Department of Surgery, Surgical Outcomes Analysis & Research, University of Massachusetts Medical School, Worcester, MA, USA

    Andrew T. Burr, YouFu Li, Jennifer F. Tseng, Reza F. Saidi, Adel Bozorgzadeh & Shimul A. Shah

  2. Solid Organ Transplantation, Department of Surgery, University of Massachusetts Medical School, 55 Lake Avenue North, S6-432, Worcester, MA, 01655, USA

    Shimul A. Shah

Authors
  1. Andrew T. Burr
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  2. YouFu Li
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  3. Jennifer F. Tseng
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  4. Reza F. Saidi
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  5. Adel Bozorgzadeh
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  6. Shimul A. Shah
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Correspondence to Shimul A. Shah.

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Burr, A.T., Li, Y., Tseng, J.F. et al. Survival After Liver Transplantation Using Hepatitis C Virus-Positive Donor Allografts: Case-Controlled Analysis of the UNOS Database. World J Surg 35, 1590–1595 (2011). https://doi.org/10.1007/s00268-011-1019-5

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  • DOI: https://doi.org/10.1007/s00268-011-1019-5

Keywords

  • Propensity Score
  • Graft Survival
  • Donor Liver
  • Matched Cohort
  • Liver Allograft