Follow up and safety of use of hepatitis C virus discordant liver transplants.

BACKGROUND

Hepatitis C virus (HCV)-discordant liver transplants (LT), nonviremic and viremic, were first shown at our center as safe and efficacious for HCV-negative recipients in the short-term. This review evaluates HCV-discordant LT long-term outcomes.

METHODS

All HCV-discordant deceased donor LT from 03/2016-06/2023 were reviewed in this retrospective, single-center study.

RESULTS

194 HCV-discordant LTs (96 (49.5 %) nucleic acid test (NAT)-negative and 98 (50.5 %) NAT-positive) were evaluated with a median follow-up of 53 months. Baseline liver biopsies of 139 (71.6 %) allografts, report 47 (24.2 %) no fibrosis, 27 (13.9 %) stage 1 fibrosis, and 65 (33.5 %) stage 2 fibrosis. Stage 2 fibrosis was higher among NAT-positive allografts (46.9 % vs. 19.8 %). Seven (6.3 %) NAT-negative allograft recipients experienced HCV transmission. One (1.1 %) NAT-positive allograft recipient experienced early HCV relapse, requiring additional treatment. All treated recipients achieved sustained viral response (SVR). There was no difference in patient or graft survival by allograft NAT status or fibrosis stage.

CONCLUSION

This is first report to show HCV-discordant LT exhibit low rates of relapse, achieve long-term SVR and have similar patient and graft survival regardless of allograft HCV viremia or fibrosis; thus, justifying their use for transplantation in the long-term.