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Long-term follow-up and outcome of liver transplantation from anti-hepatitis C virus-positive donors: a European multicentric case-control study

(2011) TRANSPLANTATION. 91(11). p.1265-1272
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Abstract
Background. The growing prevalence of hepatitis C virus (HCV) infection in the general population has resulted in an increased frequency of potential organ donors that carry the virus. Given the significant disparity between organ supply and demand for transplantation, it becomes essential to consider whether livers from anti-HCV-positive donors may be considered suitable for transplantation. Methods. Based on a multicenter European database, 694 patients with HCV-related cirrhosis underwent liver transplantation and 11% of them received the graft from anti-HCV-positive donors. Of this group, we selected 63 patients (study group) and, after a 1:1 case-control approach, compared them with 63 patients that received an anti-HCV-negative donor graft (control group). Only grafts with preperfusion liver biopsy results with a fibrosis score of not more than 1 were used for transplantation. Results. Patients who received anti-HCV-positive grafts had a cumulative survival rate of 83.6% and 61.7% at 1 and 5 years, respectively, vs. 95.1% and 68.2% for the control group. In comparing overall patient and graft survival, there was no statistically significant difference between the two groups (P = 0.22 and 0.11). Recurrence of hepatitis C tended to be more rapid in the group of patients who received anti-HCV-positive grafts, although it did not reach statistical significance (P = 0.07). Conclusions. We do not recommend the indiscriminate use of anti-HCV-positive donors, especially if HCV-RNA positive, as the use of this kind of graft could be linked to an advanced stage of fibrosis, the main risk factor we observed for earlier hepatitis C recurrence.
Keywords
Matched pair analysis, Marginal graft, Graft outcome, Hepatitis C recurrence, Genotyping, Viral hepatitis posttransplantation, FIBROSIS PROGRESSION, PATIENT SURVIVAL, LIVING DONOR, MELD SYSTEM, RNA, RECIPIENTS, GRAFTS, INFECTION, RECURRENT, ALLOGRAFTS

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Citation

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MLA
Ballarin, Roberto, Alessandro Cucchetti, Mario Spaggiari, et al. “Long-term Follow-up and Outcome of Liver Transplantation from Anti-hepatitis C Virus-positive Donors: a European Multicentric Case-control Study.” TRANSPLANTATION 91.11 (2011): 1265–1272. Print.
APA
Ballarin, R., Cucchetti, A., Spaggiari, M., Montalti, R., Di Benedetto, F., Nadalin, S., Troisi, R., et al. (2011). Long-term follow-up and outcome of liver transplantation from anti-hepatitis C virus-positive donors: a European multicentric case-control study. TRANSPLANTATION, 91(11), 1265–1272.
Chicago author-date
Ballarin, Roberto, Alessandro Cucchetti, Mario Spaggiari, Roberto Montalti, Fabrizio Di Benedetto, Silvio Nadalin, Roberto Troisi, et al. 2011. “Long-term Follow-up and Outcome of Liver Transplantation from Anti-hepatitis C Virus-positive Donors: a European Multicentric Case-control Study.” Transplantation 91 (11): 1265–1272.
Chicago author-date (all authors)
Ballarin, Roberto, Alessandro Cucchetti, Mario Spaggiari, Roberto Montalti, Fabrizio Di Benedetto, Silvio Nadalin, Roberto Troisi, Michele Valmasoni, Cristina Longo, Nicola De Ruvo, Nicola Cautero, Umberto Cillo, Antonio Daniele Pinna, Patrizia Burra, and Giorgio Enrico Gerunda. 2011. “Long-term Follow-up and Outcome of Liver Transplantation from Anti-hepatitis C Virus-positive Donors: a European Multicentric Case-control Study.” Transplantation 91 (11): 1265–1272.
Vancouver
1.
Ballarin R, Cucchetti A, Spaggiari M, Montalti R, Di Benedetto F, Nadalin S, et al. Long-term follow-up and outcome of liver transplantation from anti-hepatitis C virus-positive donors: a European multicentric case-control study. TRANSPLANTATION. 2011;91(11):1265–72.
IEEE
[1]
R. Ballarin et al., “Long-term follow-up and outcome of liver transplantation from anti-hepatitis C virus-positive donors: a European multicentric case-control study,” TRANSPLANTATION, vol. 91, no. 11, pp. 1265–1272, 2011.
@article{5738555,
  abstract     = {{Background. The growing prevalence of hepatitis C virus (HCV) infection in the general population has resulted in an increased frequency of potential organ donors that carry the virus. Given the significant disparity between organ supply and demand for transplantation, it becomes essential to consider whether livers from anti-HCV-positive donors may be considered suitable for transplantation. 
Methods. Based on a multicenter European database, 694 patients with HCV-related cirrhosis underwent liver transplantation and 11% of them received the graft from anti-HCV-positive donors. Of this group, we selected 63 patients (study group) and, after a 1:1 case-control approach, compared them with 63 patients that received an anti-HCV-negative donor graft (control group). Only grafts with preperfusion liver biopsy results with a fibrosis score of not more than 1 were used for transplantation. 
Results. Patients who received anti-HCV-positive grafts had a cumulative survival rate of 83.6% and 61.7% at 1 and 5 years, respectively, vs. 95.1% and 68.2% for the control group. In comparing overall patient and graft survival, there was no statistically significant difference between the two groups (P = 0.22 and 0.11). Recurrence of hepatitis C tended to be more rapid in the group of patients who received anti-HCV-positive grafts, although it did not reach statistical significance (P = 0.07). 
Conclusions. We do not recommend the indiscriminate use of anti-HCV-positive donors, especially if HCV-RNA positive, as the use of this kind of graft could be linked to an advanced stage of fibrosis, the main risk factor we observed for earlier hepatitis C recurrence.}},
  author       = {{Ballarin, Roberto and Cucchetti, Alessandro and Spaggiari, Mario and Montalti, Roberto and Di Benedetto, Fabrizio and Nadalin, Silvio and Troisi, Roberto and Valmasoni, Michele and Longo, Cristina and De Ruvo, Nicola and Cautero, Nicola and Cillo, Umberto and Pinna, Antonio Daniele and Burra, Patrizia and Gerunda, Giorgio Enrico}},
  issn         = {{0041-1337}},
  journal      = {{TRANSPLANTATION}},
  keywords     = {{Matched pair analysis,Marginal graft,Graft outcome,Hepatitis C recurrence,Genotyping,Viral hepatitis posttransplantation,FIBROSIS PROGRESSION,PATIENT SURVIVAL,LIVING DONOR,MELD SYSTEM,RNA,RECIPIENTS,GRAFTS,INFECTION,RECURRENT,ALLOGRAFTS}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{1265--1272}},
  title        = {{Long-term follow-up and outcome of liver transplantation from anti-hepatitis C virus-positive donors: a European multicentric case-control study}},
  url          = {{http://dx.doi.org/10.1097/TP.0b013e318219eb8f}},
  volume       = {{91}},
  year         = {{2011}},
}

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