DDW: Hepatitis C Patients Benefit with New Livers from HCV-Infected Donors

WASHINGTON, May 21 -- The best new liver for a patient with hepatitis C related cirrhosis appears to be one from an HCV-infected donor, researchers reported here.

Graft survival with livers from HCV-infected donors "is at least as good as survival with a liver from a non-infected donor and there is a trend toward better graft survival with livers from infected donors," Paul Kwo, M.D., of Indiana University in Indianapolis told attendees at Digestive Disease Week.

In a case control study, Dr. Kwo and colleagues compared survival and HCV recurrence in 37 patients with chronic HCV who received livers from infected donors with outcomes in 76 HCV patients who received livers from non-infected donors (controls).

At one year, the survival rate for grafts from infected donors was 96.8% versus a one-year graft survival rate of 86.1% for grafts from non-infected donors. But, Dr. Kwo said, the difference did not reach statistical significance.

HCV recurrence, as measured by fibrosis score, also tended to be better for livers from infected donors. The mean increase in fibrosis from four months to one year was 26% for the livers from infected donors versus a 69% increase in fibrosis for non-infected livers, "which trended toward significance (P =0.08)," he said.

Based on this study and similar reports from other liver-transplant services, Dr. Kwo said that he felt confident in recommending that HCV-infected donors be "considered as first line therapy to increase the available donor pool of organs for HCV patients needing liver transplants."

Commenting on the study, John M. Vierling, M.D., immediate past president of the American Association for the Study of Liver Diseases, noted that the waiting list for liver transplants has grown from 7,200 patients in 1999 to more than 18,000 patients today.