Allografts

from HBsAg positive donors were even used in recipients with HBV unrelated diseases. Loggi et al.[26] reported that 10 patients underwent LT from HBsAg positive donors: six patients with HBV selleck chemicals related disease and four with HBV unrelated disease (HCV or secondary biliary cirrhosis). Post-transplantation, all patients were treated with lamivudine and HBIg. Although patients transplanted for HBV related disease never cleared HBsAg, two HBsAg negative patients never tested positive for HBsAg, whereas the others experienced a HBsAg appearance, followed by spontaneous production of anti-HBs. No sign of HBV related disease developed. Therefore, liver transplant using HBsAg positive liver grafts is safe for patients with end-stage liver disease secondary to hepatitis B virus infection

in the era of highly effective antiviral therapy.[24-27] APPROXIMATELY 5% OF all potential organ donors in the USA are positive for antibody to HCV.[28] Detection of antibody to HCV by serological screening of the donor is not predictive of HCV transmission to the recipient.[29] The consequence of receiving an organ from a donor who is positive for immunoglobulin G antibody to HCV is 50% of the recipients will have detectable antibody to HCV, 74% will have detectable hepatitis C viremia by polymerase chain reaction (PCR) analysis and 35% may develop liver disease.[28] LT from an anti-HCV positive donor to an anti-HCV positive recipient does not seem http://www.selleckchem.com/products/Erlotinib-Hydrochloride.html to cause an increased morbidity or mortality in the liver recipient. The graft and patient actuarial survival were the same as the graft from an anti-HCV negative donor.[30-33] Those 上海皓元 liver recipients in whom the donor HCV strain becomes predominant can have significantly longer liver disease-free survival than recipients who retain their own HCV strain. If it were possible to test anti-HCV positive donors by PCR and genotype match PCR positive donors and recipients, superinfection

with a different strain could also be eliminated.[34] Cameron and Busuttil[35] reported that 59 patients receiving HCV positive grafts were indistinguishable from 419 patients receiving HCV negative grafts. Both graft survival and recurrence-free survival were identical between the groups with no increase in short (1-year) or long (5-year) morbidity or mortality in the HCV positive graft cohort. However, recipients of HCV positive grafts from older donors have higher rates of death and graft failure, and develop more extensive fibrosis than HCV negative graft recipients from older donors. The conclusion from all these studies is that HCV positive allografts free from fibrosis or severe inflammation are a safe option for HCV positive recipients, because patient and graft survival rates are not significantly different from those patients who receive a liver from a HCV negative donor.