Patients who do not have hepatitis C tend to do better with liver transplants from older donors than patients with hepatitis C, according to a study reported in the January 15 issue of Tranplantation.
The use of livers from donors over 50 years of age is a widespread strategy to manage the disparity between supply and demand of organs for liver transplantation, according to the study.
Mayo Clinic researchers attempted to determine the effect of such transplants from older donors on the progression of liver fibrosis and survival of the new liver in patients with and without hepatitis C.
Of the 402 patients patients involved in the study who underwent liver tissue transplants at the Mayo Clinic in Jacksonville between March 1998 to December 2001, 167 had hepatitis C and 235 did not. Liver biopsies were performed at 1, 16, and 52 weeks after transplantation and yearly thereafter.
In patients with hepatitis C, the survival of the transplanted liver was shorter when it came from older donors than younger donors. In patients without hepatitis C, the survival of the new liver tissue did not depend on donor age.
In patients with hepatitis C, a fibrosis score of three or greater was present in 17 prercent of recipients of organs from older donors after four months and in 26 percent 12 months after transplantation, compared with 8 percent after four months for those receiving organs from younger donors and 13 percent after 12 months.
"Liver transplantation with older donor grafts is associated with rapid progression of fibrosis and decreased graft survival in patients with the hepatitis C virus, but not in patients without the hepatitis C virus," concluded the researchers. "Older donor grafts should be considered preferentially for patients without the hepatitis C virus."
Other sources: Transplantation. 2004 Jan 15; 77(1): 84-92