New Donor Criteria for Liver Transplants

A study has shown that transplantation of livers obtained from extended-criteria donors, including donors with hepatitis C virus (HCV) and/or prior exposure to hepatitis B virus (HBV), resulted in similar graft and patient survival compared to patients who received HCV- or HBV-negative livers.

The transplantation of livers obtained from extended criteria donors has increased in order to help alleviate the shortage of organs. Researchers at the University of Pittsburgh's Thomas E. Starzl Transplantation Institute (PA, USA) conducted a seven-year review of liver transplant recipients who received HBC- and HCV-positive organs. The patients were divided into three groups. One group consisted of 28 patients who received both HBV- and HCV-positive livers; another group consisted of 58 patients who received HBV-positive livers; and the third group consisted of 34 patients who received HVC-positive livers.

Patient and graft survival were as follows: group one, 68% and 64%, respectively; group two, 76% and 65%, respectively; and group three, 82% and 76%, respectively. Overall, recurrent HBV occurred in four of 86 patients and no grafts were lost. Of those patients who received HCV-positive livers, 15 of 62 patients have died. Two deaths were due to HCV graft failure and another two were HCV-related. Although HCV recurrence in groups one and three were universal, the severity of recurrence and response to interferon-based therapy were comparable to HCV patients who received HCV-negative livers. Based on these findings, the researchers concluded that the use of HBV- and/or HCV-positive livers for organ donation is safe.

"When selected properly for transplantation, these organs are often of good quality, and so long as they are transplanted to the appropriate recipients, long-term results are comparable to patients who receive livers from HBV- or HCV-negative donors,” observed Amadeo Marcos, M.D., chief, clinical transplantation, at the Thomas E. Starzl Transplantation Institute.

The research results were presented at the joint scientific meeting of the American Society of Transplant Surgeons and the American Society of Transplantation in May in Seattle (WA, USA).




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