Novel Study Suggests HCV-positive Livers Safe for Transplantation

A recent study published in the journal Liver Transplantation showed patients who received a transplanted liver infected with hepatitis C virus (HCV) and were later treated for the infection performed as well in recovery as those who received an HCV-negative liver.

“What we found is that you can use hepatitis C infected livers and the results in this interim analysis are the same whether there is a need to treat organs affected by hepatitis C or not,” said senior author Shimul Shah, MD, professor of surgery, University of Cincinnati (UC) College of Medicine, in a university press release. “Everyone who received a liver affected by hepatitis C was cleared of the virus.”

In the largest study of liver transplantation in North America, 32 patients received HCV-positive livers and 32 patients received HCV-negative livers (control group) for transplantation between June 2018 and October 2019. One patient died during transplantation in the experimental group as a result of factors not related to HCV.

What we found is that you can use hepatitis C infected livers and the results in this interim analysis are the same whether there is a need to treat organs affected by hepatitis C or not.

The primary endpoint was success of HCV treatment and elimination of HCV infection. Thirty-day and 1-year graft, patient survival and perioperative complications were established as secondary outcomes.

Median age for patients in the group receiving an HCV-positive liver was 60 years vs 57 years for the control group; median donor age was 37 years. The majority of participants in both groups were white males.

Participants requiring treatment for hepatitis C received medication 47 days after liver transplant.

Approximately 63% of patients achieved sustained virological response at week 12 and 6 patients achieved end-of-treatment response, 5 remained on therapy, and 1 did not start treatment.

There were no HCV treatment failures reported and no differences in 30-day and 1-year graft and patient survival, length of hospital stay, biliary or vascular complications, or cytomegalovirus viremia between the 2 groups.

“There is a big difference between the demand and supply of livers, and previously organs affected with hepatitis C were being discarded,” said first author Nadeem Anwar, MD, professor, UC Department of Internal Medicine, in the press release. “With this study it is clear that we can help more patients get transplanted using HCV-positive organs.”