Impact of donor age on survival and fibrosis progressionin patients with hepatitis C undergoing liver transplantation using HCV + allografts

Mount Sinai Medical Center, New York, New York, United States
Liver Transplantation (Impact Factor: 4.24). 10/2006; 12(10):1496-503. DOI: 10.1002/lt.20849
Source: PubMed


Studies have suggested that the use of hepatitis C virus (HCV)-positive (HCV+) donor allografts has no impact on survival. However, no studies have examined the effect that HCV+ donor histology has upon recipient and graft survival. We evaluated the clinical outcome and impact of histological features in HCV patients transplanted using HCV+ livers. We reviewed all patients transplanted for HCV at our institution from 1988 to 2004; 39 received HCV+ allografts and 580 received HCV-negative (HCV-) allografts. Survival curves compared graft and patient survival. Each HCV+ allograft was stringently matched to a control of HCV- graft recipients. No significant difference in survival was noted between recipients of HCV+ livers and controls. Patients receiving HCV+ allografts from older donors (age > or =50 yr) had higher rates of graft failure (hazard ratio, 2.74) and death rates (hazard ratio, 2.63) compared to HCV- allograft recipients receiving similarly-aged older donor livers. Matched case-control analysis revealed that recipients of HCV+ allografts had more severe fibrosis post-liver transplantation than recipients of HCV- livers (P = 0.008). More advanced fibrosis was observed in HCV+ grafts from older donors compared to HCV+ grafts from younger donors (P = 0.012). In conclusion, recipients of HCV+ grafts from older donors have higher rates of death and graft failure, and develop more extensive fibrosis than HCV- graft recipients from older donors. Recipients of HCV+ grafts, regardless of donor age, develop more advanced liver fibrosis than recipients of HCV- grafts.

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Available from: Sukru Emre, Oct 03, 2014
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    • "No effect of donor age on survival could be detected in our present cohort. However, the overall donor age was relatively high throughout the entire study period (median 54 years, range 11–77), compared to other transplant centers [14] [31] [32] and the low number of young donors may have led to an underestimation of the effect of donor age. In order to assess the importance of donor histology in older donors, we evaluated the impact of stage of fibrosis, steatosis, and necroinflammatory activity on graft and patient survival in recipients receiving a liver from a donor aged 60 years or more. "
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