Conflict of Interest The authors of this manuscript have conflicts of interest to disclose as described by the American Journal of Transplantation. Dr. O’Leary has served on advisory boards and a speaker’s bureau for Vertex. Dr. Davis has served in a consultancy or advisory position for Abbott, Genentech, Novartis, Roche, and Vertex.
Utilization of hepatitis C antibody-positive livers: genotype dominance is virally determined
Article first published online: 30 MAY 2012
© 2012 The Authors. Transplant International © 2012 European Society for Organ Transplantation
Volume 25, Issue 8, pages 825–829, August 2012
How to Cite
O’Leary, J. G., Neri, M. A., Trotter, J. F., Davis, G. L. and Klintmalm, G. B. (2012), Utilization of hepatitis C antibody-positive livers: genotype dominance is virally determined. Transplant International, 25: 825–829. doi: 10.1111/j.1432-2277.2012.01498.x
- Issue published online: 10 JUL 2012
- Article first published online: 30 MAY 2012
- Received: 8 March 2012 Revision requested: 30 March 2012 Accepted: 18 April 2012
- donor allocation;
- extended criteria donor;
- hepatitis C;
- liver transplantation
Because of the unrelenting donor shortage, utilization of all potential liver donors is essential. However, when utilizing marginal donors it is critical to precisely characterize the risks, inform recipients of those risks, and allocate these higher risk organs to appropriate candidates. Towards this goal, we need to determine the safety and potential consequences, if any, of utilizing hepatitis C (HCV) antibody-positive donors in HCV infected recipients. To further characterize HCV antibody-positive donors, we analyzed prospectively collected serum samples from HCV antibody-positive donors transplanted into HCV RNA-positive recipients from 5/1993 to 10/2008 for HCV viral load (Roche Cobas AmpliPrep/Cobas Taqman HCV Assay) and genotype (Siemens Versant 2.0 LiPA HCV 5’ UTR/Core Assay). Seventeen of 32 (53%) HCV antibody-positive donors were RNA negative. Fifteen patients received an HCV RNA-positive donor and nine donor–recipient pairs had different genotypes or subtypes for analysis. When genotype 1 competed with a non-1 genotype, it was found in 5/6 recipients. In 2/3 cases of mismatched genotype 1 subtypes, genotype 1a dominated. Kaplan–Meier analysis of patient and graft survival and fibrosis progression did not reveal differences between patients who received an HCV antibody-positive donor that was viremic or aviremic. In conclusion, approximately half of HCV antibody-positive donors were aviremic. Viral dominance in viremic donor–recipient pairs seems virally determined.