Review Article

Liver Transplantation and Hepatitis C

Table 3

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

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

Gaglio et al. [224]200368 (23/45)12.6/28*NANA24NA87/8987/85No difference in outcomes, increased risk of cholestatic hepatitis in LDLT
Shiffman et al. [46]200476 (23/53)13.5 ± 1.1/16.2 ± 1.047.6 ± 2/47.8 ± 0.8NA36No difference79/8276/82No difference in outcomes
Humar et al. [48] 200551 (12/39)17 (14–27)/24 (17–40)*37.7 ± 9.2/42.8 ± 16.210.2 ± 4.2/<128.3Significantly severe in DDLT92/90NALDLT may be at a low risk for HCV recurrence
Garcia-Retortillo et al. [225]2004117 (22/95)11 (5–24)/11 (2–28)31 (19–58)/47 (13–86)NA22Significantly severe in LDLTNANASevere hepatitis C recurrence in LDLT
Maluf et al. [226] 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
Thuluvath and Yoo [227]2004619 (207/412)NA35.8 ± 0.4/38.9 ± 18.13.9 ± 7.3/8.4 ± 4.524NA79/8174/73Lower graft survival in LDLT
Russo et al. [228]20044234 (279/3955)NA (TB, PT and Cre were significantly worse in DDLT)37/408.1/2.624NA83/8172/75No difference in outcomes
Bozorgzadeh et al. [229]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. [230]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. [231]200526 (11/15)14 (9–19)/18 (10–31) 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. [49]200667 (15/52)16.9 ± 6.9/19.0 ± 8.3NANA24No difference93/9687/94No difference in outcomes
Terrault et al. [50]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 difference74/8268/80 fNo significant difference in patient/graft survival in experienced LDLT centers
Schmeding et al. [47]2007289 (20/269)NA38.6 ± 15.2/44.2 ± 12NA60No differenceBetter in DDLT ( )Better in DDLT ( )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. [232]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. [21]2009200 (32/168)14.6 ± 4.7/25.5 ± 5.9*35 ± 12/40 ± 16
NA60No difference81/81NALDLT is a good option for HCV cirrhosis
Jain et al. [233]2011100 (35/65)14.5 ± 3.9/16.8 ± 7.3*34.3 ± 9.3/47.2 ± 19.811 ± 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.
Abbreviations: 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.