Use of hepatitis C-infected deceased donors in liver transplantation

Research output: Contribution to journalReview article

Abstract

The use of hepatitis C-infected (HCV +) liver donors for HCV + transplant recipients was previously controversial, but mounting evidence now supports this practice. HCV-related cirrhosis accounts for 45% of the liver transplants in the United States; however, these transplant recipients have worse transplant outcomes when compared to non-HCV infected (HCV -) recipients. The optimal utility of the donor graft is therefore decreased with transplantation of HCV + recipients because the largest percentage of organs are transplanted into patients with inferior survival outcomes. Increased use of HCV + livers, which can only be transplanted into HCV + recipients, provides additional transplant liver allografts directly targeted to the recipient population at greatest need. As HCV + recipients are transplanted with previously unusable organs, more HCV - donor livers are available for the HCV - recipient population, thereby increasing the utility of HCV - grafts. Therefore, increased use of HCV + donors results in increased utility of all available liver allografts and a shorter waitlist time to transplant, because the total number of available organs is increased. This review discusses the use of HCV + donor livers in transplantation, including donor organ evaluation, hepatitis C in liver transplantation, a review of the available literature, and the future direction of HCV + donors in transplantation.

Original languageEnglish (US)
Pages (from-to)253-259
Number of pages7
JournalCurrent Hepatitis Reports
Volume9
Issue number4
DOIs
StatePublished - Nov 2010

Fingerprint

Hepatitis C
Liver Transplantation
Tissue Donors
Transplants
Liver
Allografts
Transplantation
Population
Fibrosis
Survival

Keywords

  • Extended criteria donor (ECD)
  • Hepatitis C
  • Liver transplant
  • Transplant outcomes

ASJC Scopus subject areas

  • Hepatology
  • Virology

Cite this

Use of hepatitis C-infected deceased donors in liver transplantation. / Mangus, Richard S.

In: Current Hepatitis Reports, Vol. 9, No. 4, 11.2010, p. 253-259.

Research output: Contribution to journalReview article

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AB - The use of hepatitis C-infected (HCV +) liver donors for HCV + transplant recipients was previously controversial, but mounting evidence now supports this practice. HCV-related cirrhosis accounts for 45% of the liver transplants in the United States; however, these transplant recipients have worse transplant outcomes when compared to non-HCV infected (HCV -) recipients. The optimal utility of the donor graft is therefore decreased with transplantation of HCV + recipients because the largest percentage of organs are transplanted into patients with inferior survival outcomes. Increased use of HCV + livers, which can only be transplanted into HCV + recipients, provides additional transplant liver allografts directly targeted to the recipient population at greatest need. As HCV + recipients are transplanted with previously unusable organs, more HCV - donor livers are available for the HCV - recipient population, thereby increasing the utility of HCV - grafts. Therefore, increased use of HCV + donors results in increased utility of all available liver allografts and a shorter waitlist time to transplant, because the total number of available organs is increased. This review discusses the use of HCV + donor livers in transplantation, including donor organ evaluation, hepatitis C in liver transplantation, a review of the available literature, and the future direction of HCV + donors in transplantation.

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