Implications of treating hepatitis C Virus infection among patients awaiting cadaveric liver transplant: A single-center experience

Objectives: We examined hepatitis C virus positivity among the donors in our center to investigate whether hepatitis C treatment affected liver trans - plant Model for End-Stage Liver Disease. Materials and Methods: We retrospectively reviewed all deceased-donor liver transplants performed between January 2013 and December 2014 at our center, with the primary indication of hepatitis C virus. Baseline demographic and laboratory characteristics of recipients and donors were collected. Statistical analyses were done with P values ≤.05 considered significant. Results: Seventy-five liver transplants were performed, and 62 of them were hepatitis C virus RNApositive at the time of liver transplant donor offer. In 2013, during the Pre-Direct Antiviral Agents era, 14 of 33 hepatitis C virus RNA-positive recipients (42%) were matched to hepatitis C virus-positive donors. During the Direct Antiviral Agents era in 2014, this ratio was 38% (11/29) (P =.72). The mean Model for End-Stage Liver Disease at transplant of the 62 hepatitis C virus RNA-positive recipients was 29, whereas the mean Model for End-Stage Liver Disease of 13 hepatitis C virus RNA-negative recipients was 31. This was not statistically significant (P =.25). Conclusions: Although hepatitis C virus treatment before liver transplant is an attractive option to eliminate the risk of complications because of recurrent hepatitis C virus after liver transplant, its potential effect on limiting the donor pool for the recipient must also be considered. In our observation, 40% of our donor pool consists of hepatitis C viruspositive donors. Further multiregional studies are warranted to verify this observation and to see the potential effect of direct antiviral agent treatment into waiting times and the Model for End-Stage Liver Disease at organ allocation.