Older liver donors not associated with negative outcomes in transplant recipients with hepatitis CJuly 22, 2008Receiving a liver from a donor older than age 60 does not appear to be associated with transplant failure, death or recurrent disease in the next five years among transplant patients with the hepatitis C virus, according to a report in the July issue of Archives of Surgery, one of the JAMA/Archives journals. Hepatitis C virus infection is the most common cause of the liver disease cirrhosis and the most common indication for liver transplant for U.S. adults, according to background information in the article. Currently, about 17,000 patients are on the waiting list for a liver transplant. Many medical centers have expanded donor criteria, including increasing age limits, to increase the pool of available organs. "There are concerning reports, however, in recipients with hepatitis C virus that extended criteria donors, particularly older donors, are associated with poorer outcome, especially with early and severe hepatitis C virus recurrence in the donor graft," the authors write. M.B. Majella Doyle, M.D., and colleagues at Washington University School of Medicine, St. Louis, analyzed data from 489 adult liver transplants performed at the school between 1997 and 2006. Of these patients, 187 (38.2 percent) were infected with the hepatitis C virus and 302 (61.8 percent) had other indications for liver transplant. Of patients with the hepatitis C virus, 88.1 percent were alive after one year, 78.3 percent survived three years and 69.2 percent survived five years. Donor livers were still functioning in 85.6 percent of hepatitis C virus-positive recipients after one year, 75.6 percent after three years and 65.6 percent after five years. There were no differences in rates of survival and graft (organ) survival between patients with and without hepatitis C in the short or medium term (at one, three or five years). "However, similar to other long-term transplant centers, we observed a negative effect from recurrent hepatitis C virus with a trend toward worsened long-term survival between years five and 10," the authors write. A total of 72 patients received organs from donors age 60 and older, including 24 (12.8 percent) with hepatitis C virus and 48 (15.9 percent) without the virus. There were no differences in one-, three- or five-year patient or graft survival rates when these patients-or those who received organs from donors age 65 and older-were compared with those who received organs from younger donors. Because the use of older donors has primarily occurred in the past five years, long-term comparisons were not possible. However, the early results suggest the practice is safe, the authors note. "In conclusion, overall patient and graft survival in hepatitis C virus-positive recipients is comparable with that in hepatitis C virus-negative patients, and there seems to be little, if any, adverse effect on short- and medium-term follow-up with the use of carefully selected older donor grafts in recipients with hepatitis C virus," they conclude. "Data from this series suggest that the continued use of selected older donors is a safe method of expanding the liver donor pool, even for hepatitis C-positive recipients." JAMA and Archives Journals |
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| Related Hepatitis Current Events and Hepatitis News Articles Toward explaining why hepatitis B hits men harder than women Scientists in China are reporting discovery of unusual liver proteins, found only in males, that may help explain the long-standing mystery of why the hepatitis B virus (HBV) sexually discriminates -- hitting men harder than women. Largest-ever database for liver proteins may lead to treatments for hepatitis Scientists at a group of 11 research centers in China are reporting for the first time assembly of the largest-ever collection of data about the proteins produced by genes in a single human organ. Mount Sinai finds those with more difficult to treat forms of HCV are half as likely to get treated A new study by Mount Sinai researchers has for the first time found that patients with more difficult to treat forms of hepatitis C are half as likely to initiate treatment for the disease, when compared to patients with hepatitis C that is easier to treat. Extending treatment after liver transplant may benefit patients with hepatitis C recurrence Extending hepatitis C treatment for liver transplant patients beyond current practice results in high rates of clearance of the hepatitis C virus from the blood, as well as a low rate of relapse, according to a Henry Ford Hospital study. Hepatitis B does not increase risk for pancreatic cancer A Henry Ford Hospital study found that hepatitis B does not increase the risk for pancreatic cancer - and that only age is a contributing factor. Governor recognizes stem cell research at Einstein Albert Einstein College of Medicine of Yeshiva University hosted a roundtable discussion on stem cell research with New York Governor David A. Paterson today. Liver cells grown from patients' skin cells Scientists at The Medical College of Wisconsin in Milwaukee have successfully produced liver cells from patients' skin cells opening the possibility of treating a wide range of diseases that affect liver function. Injury and hazards in home health care nursing are a growing concern Patients continue to enter home healthcare ''sicker and quicker," often with complex health problems that may require extensive nursing care. Medication effective for acute liver failure in early stages of disease The antidote for acute liver failure caused by acetaminophen poisoning also can treat acute liver failure due to most other causes if given before severe injury occurs, UT Southwestern Medical Center researchers and their colleagues at 21 other institutions have found. New aging studies improving vaccine efficacy for the elderly A new study from the Trudeau Institute in Saranac Lake, New York, demonstrates that immune system cells important for both pathogen resistance and vaccine efficacy live longer in older animals but because of this longevity acquire functional defects. More Hepatitis Current Events and Hepatitis News Articles |
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