HCV-positive livers give similar outcomes as healthy livers: study

Last Updated: 2016-04-20

By Megan Brooks

NEW YORK (Reuters Health) - Medium- to long-term outcomes for hepatitis C virus (HCV)-positive liver transplant patients who receive an HCV-positive liver are on par with their peers who receive a healthy liver, a new study suggests.

"Over the past two decades, mainly due to shortages in organs, the use of HCV-positive organs for liver transplantation has tripled," Dr. Zobair Younossi of Inova Fairfax Hospital, Falls Church, Virginia, notes in a news release from The International Liver Congress 2016 where he presented the results April 14.

Using data from Scientific Registry of Transplant Recipients (SRTR) for the United States (1995-2013), the researchers assessed the medium- and long-term outcomes of 33,668 HCV-positive liver transplant (LT) recipients who received an HCV-positive organ. The mean recipient age was 54, 74% were male and 71% white.

Overall, 1,930 patients (5.7%) received an HCV-positive organ. The proportion of HCV-positive liver transplants gradually rose from 2.9% in 1995 to 9.4% in 2013.

HCV-positive donors were older than HCV-negative donors, had significantly more history of drug abuse, were less frequently non-heart-beating at the time of procurement and were equally likely to be male, have history of type 2 diabetes and cancer.

Posttransplant mortality in recipients of HCV-positive livers was 12.5% at one year, 24.2% at three years, 33.0% at five years, and 47.5% at 10 years. Corresponding rates of graft loss were 2.2%, 4.8%, 7.5% and 13.9%.

Importantly, Dr. Younossi told Reuters Health by email, "the outcomes of HCV-positive recipients who received HCV-positive donor organs were shown to be similar to those HCV-positive recipients who received HCV-negative organs."

"There was also no association of a donor's HCV positivity with the time to post-transplant death and time to graft loss in a proportion hazard survival analysis after adjustment for the year of transplantation," the authors said in a meeting abstract.

"Given the shortage of organs for liver transplantation, this approach may provide an option for those patients with HCV liver disease who face long waiting times. In fact, with the development of highly effective and well tolerated regimens for HCV, these patients' post-transplant outcomes may improve further with anti-HCV treatment. This issue is important and needs to be studied further," Dr. Younossi told Reuters Health.

"This study clearly demonstrates a greater opportunity for use of HCV positive livers over the coming years due to their comparable outcomes with healthy livers" said professor Tom Hemming Karlsen, vice-secretary of the European Association for the Study of the Liver (EASL), in the news release. "With the number of people waiting for a liver transplant expected to rise, the study results should give hope over the coming years for those on the waiting list."

The study had no funding and the authors have no disclosures.

SOURCE: http://bit.ly/1VFSskr

International Liver Congress 2016.