Use of Hepatitis C-Positive Donor Livers in Liver Transplantation
- 218 Downloads
Purpose of Review
The purpose of this article is to review recent literature regarding the use of hepatitis C virus (HCV)-positive donor livers in liver transplantation. Given the prevalence of HCV-positive patients on the waitlist coupled with high waitlist mortality, use of HCV-positive livers may be a means to meet patient needs. This review seeks to primarily answer the following questions: can HCV-positive livers be used safely and effectively? Are new direct-acting antiviral medications safe and effective in HCV-positive liver recipients?
Use of HCV-positive donor livers for liver transplantation in HCV-positive recipients is increasing. These donor livers have equivalent patient and graft survival when compared to HCV-negative donor livers in HCV-positive liver transplant recipients. Recent studies suggest that use of direct-acting antiviral medications in HCV-positive liver transplant recipients can be successful, although there is insufficient data for their use in recipients of HCV-positive donor livers.
HCV-positive donor livers may be safely and effectively used in HCV-positive liver transplant recipients. Direct-acting antiviral medications appear safe and effective in HCV-positive liver transplant recipients, but data on their efficacy in HCV-positive donor liver transplant recipients are limited. Future research should focus on the use of HCV-positive donor livers in HCV-negative liver transplant recipients.
KeywordsHepatitis C virus Liver transplantation Direct-acting antivirals HCV-positive organs HCV-positive livers HCV-positive liver transplantation
Compliance with Ethical Standards
Conflict of Interest
Daniel Bushyhead and David Goldberg each declare no potential conflicts of interest.
Human and Animal Rights and Informed Consent
All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 1.Viral hepatitis—statistics & surveillance. Center for Disease Control and Prevention. 2016. http://www.cdc.gov/hepatitis/statistics/index.htm. Accessed 11 Nov 2016.
- 2.Organ Procurement and Transplantation Network—2014 data report. 2016. https://optn.transplant.hrsa.gov/. Accessed 3 June 2016.
- 5.• Northup PG, Argo CK, Nguyen DT, McBride MA, Kumer SC, Schmitt TM, et al. Liver allografts from hepatitis C positive donors can offer good outcomes in hepatitis C positive recipients: a US National Transplant Registry analysis. Transpl Int. 2010;23:1038–44. doi: 10.1111/j.1432-2277.2010.01092.x. This is the largest study to analyze outcomes for HCV-positive donor livers in HCV-positive liver transplant recipients. CrossRefPubMedGoogle Scholar
- 8.Ballarin R, Cucchetti A, Spaggiari M, Montalti R, Di Benedetto F, Nadalin S, et al. Long-term follow-up and outcome of liver transplantation from anti-hepatitis C virus-positive donors: a European multicentric case-control study. Transplantation. 2011;91:1265–72. doi: 10.1097/TP.0b013e318219eb8f.CrossRefPubMedGoogle Scholar
- 20.• Forns X, Charlton M, Denning J, McHutchison JG, Symonds WT, Brainard D, et al. Sofosbuvir compassionate use program for patients with severe recurrent hepatitis C after liver transplantation. Hepatology. 2015;61:1485–94. doi: 10.1002/hep.27681. This article examined the safety and efficacy of direct acting antiviral medications in patients with severe liver disease. CrossRefPubMedGoogle Scholar
- 23.Leroy V, Dumortier J, Coilly A, Sebagh M, Fougerou-Leurent C, Radenne S, et al. Efficacy of sofosbuvir and daclatasvir in patients with fibrosing cholestatic hepatitis C after liver transplantation. Clin Gastroenterol Hepatol. 2015;13:1993–2001.e1-2. doi: 10.1016/j.cgh.2015.05.030.
- 26.Araiz JJ, Serrano MT, García-Gil FA, Lacruz EM, Lorente S, Sánchez JI, et al. Intention-to-treat survival analysis of hepatitis C virus/human immunodeficiency virus coinfected liver transplant: is it the waiting list? Liver Transpl. 2016;22:1186–96. doi: 10.1002/lt.24474.CrossRefPubMedGoogle Scholar
- 30.Zepatier for treatment of hepatitis C-negative patients who receive kidney transplants from hepatitis C-positive donors (HCV). ClinicalTrials.gov. 2016. Accessed 20 November 2016.Google Scholar