Outcomes of living donor liver transplantation for hepatitis C virus-positive recipients in Japan: Results of a nationwide survey

Nobuhisa Akamatsu, Yasuhiko Sugawara, Norihiro Kokudo, Susumu Eguchi, Toshiyoshi Fujiwara, Hideki Ohdan, Hiroaki Nagano, Akinobu Taketomi, Yuko Kitagawa, Mitsuo Shimada, Yonson Ku, Katsuhiko Yanaga, Ken Shirabe, Toru Ikegami, Masashi Mizokami, Masahiro Takeuchi, Yoshihiko Maehara

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Abstract

A nationwide survey of living donor liver transplantation (LDLT) for hepatitis C virus (HCV)-positive recipients was performed in Japan. A total of 514 recipients are reported and included in the study. The cumulative patient survival rate at 5 and 10 years was 72% and 63%, respectively. Of the 514 recipients, 142 patients (28%) died until the end of the observation, among which the leading cause was recurrent hepatitis C (42 cases). According to Cox regression multivariate analysis, donor age (>40), non-right liver graft, acute rejection episode, and absence of a sustained virologic response were independent prognostic factors. Of the 514 recipients, 361 underwent antiviral treatment mainly with pegylated-interferon and ribavirin (preemptive treatment in 150 patients and treatment for confirmed recurrent hepatitis in 211). The dose reduction rate and discontinuation rate were 40% and 42%, respectively, with a sustained virologic response rate of 43%. In conclusion, patient survival of HCV-positive recipients after LDLT was good, with a 10-year survival of 63%. Right liver graft might be preferable for HCV-positive recipients in an LDLT setting.

Original languageEnglish
Pages (from-to)767-774
Number of pages8
JournalTransplant International
Volume27
Issue number8
DOIs
Publication statusPublished - 2014 Aug

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Keywords

  • hepatitis C virus
  • living donor liver transplantation
  • nationwide survey

ASJC Scopus subject areas

  • Transplantation

Cite this

Akamatsu, N., Sugawara, Y., Kokudo, N., Eguchi, S., Fujiwara, T., Ohdan, H., Nagano, H., Taketomi, A., Kitagawa, Y., Shimada, M., Ku, Y., Yanaga, K., Shirabe, K., Ikegami, T., Mizokami, M., Takeuchi, M., & Maehara, Y. (2014). Outcomes of living donor liver transplantation for hepatitis C virus-positive recipients in Japan: Results of a nationwide survey. Transplant International, 27(8), 767-774. https://doi.org/10.1111/tri.12329