The use of hepatitis B core antibody-positive donor livers does not appear to have a deleterious effect on graft survival in liver transplantation for hepatitis C

S. Rayhill, Jonathan M. Schwartz, J. Ham, R. Carithers, Y. Lei, R. Bhattacharya, I. Liou, C. Landis, A. Lamaye, R. Rakita, A. Dick, P. Healey, J. Halldorson, R. Bhakthavatsalam, J. Perkins, J. Reyes

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Abstract

Introduction The use of hepatitis B core antibody-positive donor livers (HBcAb +) has steadily increased. According to a recent multivariate analysis of United Network for Organ Sharing (UNOS) data, there was no significant increase in the risk of using these donors. The increased risk among the hepatitis C virus (HCV)-positive subgroup noted in a univariate model disappeared upon multivariate analysis. However, deeper scrutiny may show that HCV-positive recipients may be at increased risk with HBcAb + donor livers, as they require simultaneous treatment with two antiviral regimens there may be deleterious interactions between the two viruses. Thus, the issue of HBcAb + donors for HCV-positive recipients merits more detailed analysis. Methods Using UNOS registry data of all liver transplantations performed during the Model for End-Stage Liver Disease era from February 2002 through November 2007, we analyzed graft survival using Kaplan-Meier and Cox regression analyses. Results Of the 12,543 HCV-positive recipients, 2,543 received HBcAb - livers and 853 received HBcAb + livers. While Kaplan- Meier analysis showed significantly lower graft survival among HCV-negative recipients of HBcAb + livers (P = .0001), there was no significant effect on graft survival among the HCV-positive population (P = .2). To detect an early effect in HCV-positive recipients, we examined 1-year graft survival, observing no significant difference (P = .3). To exclude a possible late effect, we examined graft survival in the HCV-positive population conditional upon surviving at least 1 year after transplantation; no significant difference was observed (P = .6). The elimination of potentially confounding codiagnoses, such as hepatitis B virus, alcoholism, acute graft failure, and hepatocellular cancer did not alter the findings. On univariate analysis, the lack of a significant effect persisted among the HCV population. However, the significant effect observed in the univariate model for the HCV-negative population became insignificant when combined with other risk factors in the multivariate model. Conclusion The use of HBcAb + livers in recipients with HCV did not appear to have a significant impact on grat survival.

Original languageEnglish (US)
Pages (from-to)4141-4144
Number of pages4
JournalTransplantation Proceedings
Volume42
Issue number10
DOIs
StatePublished - Dec 2010
Externally publishedYes

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Hepatitis B Antibodies
Graft Survival
Hepatitis C
Hepacivirus
Liver Transplantation
Liver
Information Dissemination
Population
Multivariate Analysis
End Stage Liver Disease
Kaplan-Meier Estimate
Liver Neoplasms
Hepatitis B virus
Alcoholism
Antiviral Agents
Registries
Transplantation
Regression Analysis

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

The use of hepatitis B core antibody-positive donor livers does not appear to have a deleterious effect on graft survival in liver transplantation for hepatitis C. / Rayhill, S.; Schwartz, Jonathan M.; Ham, J.; Carithers, R.; Lei, Y.; Bhattacharya, R.; Liou, I.; Landis, C.; Lamaye, A.; Rakita, R.; Dick, A.; Healey, P.; Halldorson, J.; Bhakthavatsalam, R.; Perkins, J.; Reyes, J.

In: Transplantation Proceedings, Vol. 42, No. 10, 12.2010, p. 4141-4144.

Research output: Contribution to journalArticle

Rayhill, S, Schwartz, JM, Ham, J, Carithers, R, Lei, Y, Bhattacharya, R, Liou, I, Landis, C, Lamaye, A, Rakita, R, Dick, A, Healey, P, Halldorson, J, Bhakthavatsalam, R, Perkins, J & Reyes, J 2010, 'The use of hepatitis B core antibody-positive donor livers does not appear to have a deleterious effect on graft survival in liver transplantation for hepatitis C', Transplantation Proceedings, vol. 42, no. 10, pp. 4141-4144. https://doi.org/10.1016/j.transproceed.2010.09.023
Rayhill, S. ; Schwartz, Jonathan M. ; Ham, J. ; Carithers, R. ; Lei, Y. ; Bhattacharya, R. ; Liou, I. ; Landis, C. ; Lamaye, A. ; Rakita, R. ; Dick, A. ; Healey, P. ; Halldorson, J. ; Bhakthavatsalam, R. ; Perkins, J. ; Reyes, J. / The use of hepatitis B core antibody-positive donor livers does not appear to have a deleterious effect on graft survival in liver transplantation for hepatitis C. In: Transplantation Proceedings. 2010 ; Vol. 42, No. 10. pp. 4141-4144.
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abstract = "Introduction The use of hepatitis B core antibody-positive donor livers (HBcAb +) has steadily increased. According to a recent multivariate analysis of United Network for Organ Sharing (UNOS) data, there was no significant increase in the risk of using these donors. The increased risk among the hepatitis C virus (HCV)-positive subgroup noted in a univariate model disappeared upon multivariate analysis. However, deeper scrutiny may show that HCV-positive recipients may be at increased risk with HBcAb + donor livers, as they require simultaneous treatment with two antiviral regimens there may be deleterious interactions between the two viruses. Thus, the issue of HBcAb + donors for HCV-positive recipients merits more detailed analysis. Methods Using UNOS registry data of all liver transplantations performed during the Model for End-Stage Liver Disease era from February 2002 through November 2007, we analyzed graft survival using Kaplan-Meier and Cox regression analyses. Results Of the 12,543 HCV-positive recipients, 2,543 received HBcAb - livers and 853 received HBcAb + livers. While Kaplan- Meier analysis showed significantly lower graft survival among HCV-negative recipients of HBcAb + livers (P = .0001), there was no significant effect on graft survival among the HCV-positive population (P = .2). To detect an early effect in HCV-positive recipients, we examined 1-year graft survival, observing no significant difference (P = .3). To exclude a possible late effect, we examined graft survival in the HCV-positive population conditional upon surviving at least 1 year after transplantation; no significant difference was observed (P = .6). The elimination of potentially confounding codiagnoses, such as hepatitis B virus, alcoholism, acute graft failure, and hepatocellular cancer did not alter the findings. On univariate analysis, the lack of a significant effect persisted among the HCV population. However, the significant effect observed in the univariate model for the HCV-negative population became insignificant when combined with other risk factors in the multivariate model. Conclusion The use of HBcAb + livers in recipients with HCV did not appear to have a significant impact on grat survival.",
author = "S. Rayhill and Schwartz, {Jonathan M.} and J. Ham and R. Carithers and Y. Lei and R. Bhattacharya and I. Liou and C. Landis and A. Lamaye and R. Rakita and A. Dick and P. Healey and J. Halldorson and R. Bhakthavatsalam and J. Perkins and J. Reyes",
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T1 - The use of hepatitis B core antibody-positive donor livers does not appear to have a deleterious effect on graft survival in liver transplantation for hepatitis C

AU - Rayhill, S.

AU - Schwartz, Jonathan M.

AU - Ham, J.

AU - Carithers, R.

AU - Lei, Y.

AU - Bhattacharya, R.

AU - Liou, I.

AU - Landis, C.

AU - Lamaye, A.

AU - Rakita, R.

AU - Dick, A.

AU - Healey, P.

AU - Halldorson, J.

AU - Bhakthavatsalam, R.

AU - Perkins, J.

AU - Reyes, J.

PY - 2010/12

Y1 - 2010/12

N2 - Introduction The use of hepatitis B core antibody-positive donor livers (HBcAb +) has steadily increased. According to a recent multivariate analysis of United Network for Organ Sharing (UNOS) data, there was no significant increase in the risk of using these donors. The increased risk among the hepatitis C virus (HCV)-positive subgroup noted in a univariate model disappeared upon multivariate analysis. However, deeper scrutiny may show that HCV-positive recipients may be at increased risk with HBcAb + donor livers, as they require simultaneous treatment with two antiviral regimens there may be deleterious interactions between the two viruses. Thus, the issue of HBcAb + donors for HCV-positive recipients merits more detailed analysis. Methods Using UNOS registry data of all liver transplantations performed during the Model for End-Stage Liver Disease era from February 2002 through November 2007, we analyzed graft survival using Kaplan-Meier and Cox regression analyses. Results Of the 12,543 HCV-positive recipients, 2,543 received HBcAb - livers and 853 received HBcAb + livers. While Kaplan- Meier analysis showed significantly lower graft survival among HCV-negative recipients of HBcAb + livers (P = .0001), there was no significant effect on graft survival among the HCV-positive population (P = .2). To detect an early effect in HCV-positive recipients, we examined 1-year graft survival, observing no significant difference (P = .3). To exclude a possible late effect, we examined graft survival in the HCV-positive population conditional upon surviving at least 1 year after transplantation; no significant difference was observed (P = .6). The elimination of potentially confounding codiagnoses, such as hepatitis B virus, alcoholism, acute graft failure, and hepatocellular cancer did not alter the findings. On univariate analysis, the lack of a significant effect persisted among the HCV population. However, the significant effect observed in the univariate model for the HCV-negative population became insignificant when combined with other risk factors in the multivariate model. Conclusion The use of HBcAb + livers in recipients with HCV did not appear to have a significant impact on grat survival.

AB - Introduction The use of hepatitis B core antibody-positive donor livers (HBcAb +) has steadily increased. According to a recent multivariate analysis of United Network for Organ Sharing (UNOS) data, there was no significant increase in the risk of using these donors. The increased risk among the hepatitis C virus (HCV)-positive subgroup noted in a univariate model disappeared upon multivariate analysis. However, deeper scrutiny may show that HCV-positive recipients may be at increased risk with HBcAb + donor livers, as they require simultaneous treatment with two antiviral regimens there may be deleterious interactions between the two viruses. Thus, the issue of HBcAb + donors for HCV-positive recipients merits more detailed analysis. Methods Using UNOS registry data of all liver transplantations performed during the Model for End-Stage Liver Disease era from February 2002 through November 2007, we analyzed graft survival using Kaplan-Meier and Cox regression analyses. Results Of the 12,543 HCV-positive recipients, 2,543 received HBcAb - livers and 853 received HBcAb + livers. While Kaplan- Meier analysis showed significantly lower graft survival among HCV-negative recipients of HBcAb + livers (P = .0001), there was no significant effect on graft survival among the HCV-positive population (P = .2). To detect an early effect in HCV-positive recipients, we examined 1-year graft survival, observing no significant difference (P = .3). To exclude a possible late effect, we examined graft survival in the HCV-positive population conditional upon surviving at least 1 year after transplantation; no significant difference was observed (P = .6). The elimination of potentially confounding codiagnoses, such as hepatitis B virus, alcoholism, acute graft failure, and hepatocellular cancer did not alter the findings. On univariate analysis, the lack of a significant effect persisted among the HCV population. However, the significant effect observed in the univariate model for the HCV-negative population became insignificant when combined with other risk factors in the multivariate model. Conclusion The use of HBcAb + livers in recipients with HCV did not appear to have a significant impact on grat survival.

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