Older Donor Grafts Suitable for Liver Transplant Recipients With Hepatitis C Virus

New research suggests that use of older donor grafts does not compromise outcomes in liver transplant recipients with hepatitis C virus (HCV). HCV cirrhosis is the main reason for liver transplantation in the United States, but it is linked to HCV recurrence, an increased risk of graft loss, and reduced survival, Dr. William C. Chapman, from Washington University School of Medicine in St. Louis, and colleagues note in the Archives of Surgery for July. Whether older donor grafts are suitable for transplant recipients with HCV was unclear.

Dr. Chapman's team analyzed outcomes in 489 adults who received liver transplants at one center between 1997 and 2006. Overall, grafts from "carefully selected" donors aged 60 years or older were used in 24 of 187 recipients with HCV (12.8%) and 48 of 302 without HCV (15.9%).

Five-year patient and graft survival rates in HCV-positive recipients were 69.2% and 65.6%, respectively, which did not differ significantly from the rates seen in their HCV-negative peers.

In both HCV-positive and HCV-negative recipients, there was no evidence that use of grafts from older donors impaired short- or medium-term patient or graft survival, the report indicates.

"Data from this series suggest that the continued use of selected older donors is a safe method of expanding the liver donor pool, even for HCV-positive recipients," the authors conclude.

Arch Surg 2008;143:679-685.

Reviewed by Ramaz Mitaishvili, MD

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