Clinical

Hepatitis virus-positive livers OK for transplants

Last Updated: 2005-05-25 14:24:17 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Livers positive for hepatitis B core antigen (HBcAb+) or for hepatitis C (HCV) are safe for transplantation into patients with the same infection, according to a presentation at the sixth annual American Transplant Congress in Seattle, Washington.

"The big problem in transplantation is lack of available organs," presenter Dr. Michael E. de Vera told Reuters Health. "Each year, 18,000 people are listed (on waiting lists) and only 5000 or 6000 transplants are performed, so we lose a lot of people while waiting for organs. When used appropriately, transplanting HBcAb+ or HCV+ livers is a way to expand the donor pool."

Dr. de Vera's group reviewed outcomes for patients who received transplants at the University of Pittsburgh between 1997 and 2004. Included were 28 who received HBcAb+/HCV+ livers (group I), 58 who received HBcAb+/HCV- livers (group II) and 34 who received HbcAb-/HCV+ livers (group III). Those receiving hepatitis-positive livers had histories of infection themselves, Dr. de Vera said.

Patient survival was 68% in group I, 76% in group II and 82% in group III. Corresponding graft survival was 64%, 65% and 76%. No grafts were lost from HBV recurrence. Of 15 deaths in patients who received HCV+ grafts, two were due to HCV graft failure and two were HCV-related.

"Although HCV recurrence in groups I and III was universal, the severity of recurrence and response to interferon-based therapy was comparable to HCV patients who received HCV negative livers," the presenters note in their abstract.

"In an 8-year period there were over 100 liver transplants using these donors, and in that same time frame we did over 1000 liver transplants, so about 10% were hepatitis positive, which is a significant number," Dr. de Vera said. "These data validate that practice."