Review Article

Living-Donor Liver Transplantation and Hepatitis C

Table 2

Studies comparing living-donor liver transplantation and deceased-donor liver transplantation in patients with hepatitis C cirrhosis.

AuthorYearn (LDLT/DDLT)MELD score (LDLT/DDLT)Donor age (LDLT/DDLT)Cold ischemia time (h) (LDL/DDLT)Follow-up
(mo)
Histologic progressionPatient survival LDLT/DDLT (%)Graft survival LDLT/DDLT (%)Comments

Gaglio et al. [144]200368 (23/45)12.6/28*NANA24NA87/8987/85No difference in outcomes, increased risk of cholestatic hepatitis in LDLT
Garcia-Retortillo et al. [145] 2004117 (22/95)11 (5–24)/11 (2–28)31 (19–58)/47 (13–86)#NA22Significantly severe in LDLTNANASevere hepatitis C recurrence in LDLT
Thuluvath and Yoo [146]2004619 (207/412)NA35.8 ± 0.4/38.9 ± 18.1#3.9 ± 7.3/8.4 ± 4.524NA79/8174/73Lower graft survival in LDLT
Humar et al. [85] 200551 (12/39)17 (14–27)/24 (17–40)*37.7 ± 9.2/42.8 ± 16.2#10.2 ± 4.2/<128.3Significantly severe in DDLT92/90NALDLT may be at a low risk for HCV recurrence
Shiffman et al. [84]200476 (23/53)13.5 ± 1.1/16.2 ± 1.047.6 ± 2/47.8 ± 0.8NA36No difference79/8276/82No difference in outcomes
Maluf et al. [86] 2005126 (29/97)13.2 ± 1.1/21 ± 0.8*NA0.6 ± 0.2/7.5 ± 2.872NA67/7064/69No difference in survival, more rejection in DDLT and biliary complications in LDLT
Russo et al. [87]20044234 (279/3955)NA (TB, PT and Cre were significantly worse in DDLT)37/40#8.1/2.624NA83/8172/75No difference in outcomes
Bozorgzadeh et al. [88]2004100 (35/65)14.9 ± 4/15.9 ± 5.334.6 ± 9.7/49.2 ± 20.4NA39No difference89/7583/64No difference in outcomes
Van Vlierberghe et al. [89] 200443 (17/26)15 ± 9/15 ± 831 ± 8/48 ± 173.1 ± 1.3/11.1 ± 2.612No differenceNo difference (Presented with only figure)No difference (Presented with only figure)No difference in outcomes in short-term
Schiano et al. [90]200526 (11/15)14 (9–19)/18 (10–31)
P = 0.05
33 (20–54)/47 (13–73)0.6 (0.3–1.0)/10 (4.4–20)24NA73/8073/80No difference in survival, accelerated viral load increase in LDLT
Guo et al. [91]200667 (15/52)16.9 ± 6.9/19.0 ± 8.3NANA24No difference93/9687/94No difference in outcomes
Terrault et al. [92]2007275 (181/94)14 (6–40)/18 (7–40)*38 (19–57)/41 (9–72)0.8 (0.1–8)/6.7 (0.2–10)36No difference74/8268/80No significant difference in patient/graft survival in experienced LDLT centers
Schmeding et al. [93]2007289 (20/269)NA38.6 ± 15.2/44.2 ± 12NA60No differenceBetter in DDLT (P = 0.011)Better in DDLT (P = 0.006)LDLT does not increase the risk and severity of HCV recurrence. No difference in patient/graft survival when HCC beyond Milan excluded.
Selzner et al. [94]2008201 (46/155)14 (7–39)/17 (6–40)38 (19–59)/46 (11–79)#1.5 (0.5–4.9)/7.5 (1.1–16)60Significantly severe in DDLT84/7876/74Donor age, rather than transplant approach, affects the progression of HCV
Gallegos-Orozco et al. [39]2009200 (32/168)14.6 ± 4.7/25.5 ± 5.9*35 ± 12/40 ± 16
P = 0.05
NA60No difference81/81NALDLT is a good option for HCV cirrhosis
Jain et al. [95]2011100 (35/65)14.5 ± 3.9/16.8 ± 7.3*34.3 ± 9.3/47.2 ± 19.8#11 ± 3.1 in DDLT84Significantly severe in DDLT at all time points77/6571/46Both patient/graft survival and histologic findings were better in LDLT

MELD score is significantly higher in DDLT.
Donor age is significantly higher in DDLT.
Cold ischemia time is significantly longer in DDLT.
Cre: creatinine; DDLT: deceased-donor liver transplantation; LDLT: living-donor liver transplantation; MELD: model for end-stage liver disease; NA: not available; PT: prothombin-time; TB: total bilirubin.