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The Optimal Liver for Transplant in Hepatitis-C Patients: Presented at DDW
By Bruce Sylvester
WASHINGTON, DC -- May 22, 2007 -- New research suggests that hepatitis-C- (HCV) infected patients receiving livers from HCV-infected donors have a slower rate of fibrosis progression at 1 year than those receiving uninfected livers.
The findings were presented at a press briefing here at Digestive Diseases Week (DDW).
"The implications are potentially highly important," said presenter and investigator Paul Kwo, MD, associate professor of medicine and medical director of liver transplantation, Indiana University School of Medicine, Indianapolis.
"Many people live 'peacefully' with hepatitis C infection, but when they die of other causes, their livers have not been considered to be eligible for transplantation. Our study suggests that survival rates for recipients are at least as good with cadaveric hepatitis-C-infected, noncirrhotic livers as with uninfected livers. This could mean the availability of many more cadaveric livers for transplant, where there is a critical shortage now," said Dr. Kwo.
The investigators compared transplant outcomes for liver recipients from HCV-infected donors to those for standard, nonextended criteria (ECD) donors. They analyzed data from 38 liver recipients and 76 ECD donors, data extracted from a transplant center registry, UNOS (United Network for Organ Sharing), and original on-site donor data charts.
Thirty percent of all donors met non-ECD criteria (standard donors) and were included as potential matches for the case-control study. The researchers matched each HCV-positive liver donor recipient to 2 standard donor recipients
They then analyzed recipient data for graft survival and patient survival at 3 months, 1 year, and 2 years. They also noted perioperative death, HCV recurrence, and 4-month and 1-year fibrosis.
The researchers discovered that when HCV-positive livers were used, there was no difference in survival rates compared with patients receiving uninfected livers. And they reported that the rate of fibrosis appeared to be slower in recipients of HCV-infected livers.
"The use of HCV-positive donors may be considered as a first-line therapy to increase the available donor pool of organs in those undergoing OLT for HCV-related cirrhosis," the authors concluded.
"We need more organ options for hepatitis-C patients," added press briefing moderator John Vierling, MD, professor of medicine, chief of hepatology, and director of Baylor Liver Health, Baylor University College of Medicine in Houston, Texas. "This could go a long way to meeting the need for more donors."
[Presentation title: Use of Hepatitis C-infected Donors in Liver Transplantation: A Case-Control Study]
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