Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. May 27, 2022; 14(5): 984-991
Published online May 27, 2022. doi: 10.4254/wjh.v14.i5.984
Impact of utilization of hepatitis C positive organs in liver transplant: Analysis of united network for organ sharing database
Amaninder Dhaliwal, Banreet Dhindsa, Daryl Ramai, Harlan Sayles, Saurabh Chandan, Rajani Rangray
Amaninder Dhaliwal, Department of Gastroenterology and Hepatology, Moffitt Cancer Center, Tampa, FL 33612, United States
Banreet Dhindsa, Department of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, NE 68198, United States
Daryl Ramai, Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, NY 11201, United States
Harlan Sayles, Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE 68198, United States
Saurabh Chandan, Rajani Rangray, Department of Gastroenterology and Hepatology, Creighton University Medical Center, Omaha, NE 68124, United States
Author contributions: Dhaliwal A analysis and interpretation of data, drafting the article; Dhindsa B drafting the article; Ramai D acquisition of data; Sayles H analysis and interpretation of data; Chandan S critical revision; Rangray R critical revision, final approval.
Institutional review board statement: No IRB approval needed as this is a database study.
Conflict-of-interest statement: The authors deny any conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amaninder Dhaliwal, MD, Academic Fellow, Department of Gastroenterology and Hepatology, Moffitt Cancer Center, 12902 USF Magnolia Drive, FOB 2 GI Program, Tampa, FL 33612, United States. dramaninderdhaliwal@gmail.com
Received: April 4, 2021
Peer-review started: April 4, 2021
First decision: July 6, 2021
Revised: August 6, 2021
Accepted: April 9, 2022
Article in press: April 9, 2022
Published online: May 27, 2022
Abstract
BACKGROUND

The utility of hepatitis C virus (HCV) organs has increased after the Food and Drug Administration approval of direct acting anti-viral (DAA) medications for the HCV treatment. The efficacy of DAA in treating HCV is nearly 100%.

AIM

To analyze the United Network for Organ Sharing (UNOS) database to compare the survival rates between the hepatitis C positive donors and negative recipients and hepatitis C negative donors and recipients.

METHODS

We analyzed the adult patients in UNOS database who underwent deceased donor liver transplant from January 2014 to December 2017. The primary endpoint was to compare the survival rates among the four groups with different hepatitis C donor and recipient status: (Group 1) Both donor and recipient negative for HCV (Group 2) Negative donor and positive recipient for HCV (Group 3) Positive donor and negative recipient for HCV (Group 4) Both positive donor and recipient for HCV. SAS 9.4 software was used for the data analysis. Kaplan Meier log rank test was used to analyze the estimated survival rates among the four groups.

RESULTS

A total of 24512 patients were included: Group 1: 16436, Group 2: 6174, Group 3: 253 and Group 4: 1649. The 1-year (Group 1: 91.8%, Group 2: 92.12%, Group 3: 87%, Group 4: 92.8%), 2-year (Group 1: 88.4%, Group 2: 88.1%, Group 3: 84.3%, Group 4: 87.5%), 3-year (Group 1: 84.9%, Group 2: 84.3%, Group 3: 75.9%, Group 4: 83.2%) survival rates showed no statistical significance among the four groups. Kaplan Meier log rank test did not show any statistical significance difference in the estimated survival rates between Group 3 vs all the other groups.

CONCLUSION

The survival rates in hepatitis C positive donors and negative recipients are similar as compared to both hepatitis C negative donors and recipients. This could be due to the use of DAA therapy with cure rates of nearly 100%. This study supports the use of hepatitis C positive organs in the selected group of recipients with and without HCV infection. Further long-term studies are needed to further validate these findings.

Keywords: Hepatitis C, Liver transplant, Survival, United Network for Organ Sharing, Direct acting anti-viral

Core Tip: Due to the limited availability of donor organs and high mortality rate on the transplant waiting list, newer strategies are needed. Use of direct acting anti-viral agents have led to high success rates for hepatitis C virus (HCV) treatment. Our study shows, the survival rates in hepatitis C positive donors and negative recipients are similar as compared to both hepatitis C negative donors and recipients. This study supports the use of hepatitis C positive organs in the selected group of recipients with and without HCV infection.