Institute of Digestive Health & Liver Diseases, Mercy Medical Center, Baltimore, Maryland, USA.
Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Am J Gastroenterol. 2020 Jul;115(7):1045-1054. doi: 10.14309/ajg.0000000000000583.
There are only limited data on the survival outcomes after transplanting HCV RNA-positive liver into HCV RNA-negative recipients. The objective of our study was to determine whether there were graft and patient survival differences when HCV-negative patients received HCV RNA (nucleic acid amplification testing [NAT] positive)-positive liver grafts.
We queried the United Network for Organ Sharing data sets from January 2014 to December 2018, and recipients (N = 24,724) were stratified into 6 groups based on the status of HCV antibody and RNA of recipients and donors. The Cox proportional hazard regression was used to estimate the relationship between groups and 1-year post-LT graft or patient survival.
During the study period, 1,358 recipients received NAT-positive liver grafts. Two hundred ten of the recipients were HCV negative. During the same period, 707 HCV antibody-positive but NAT-negative grafts were transplanted into 516 HCV-positive and 191 HCV-negative recipients. There were no differences in survival in HCV-positive recipients whether they received NAT-positive grafts (n = 1,148) or HCV antibody-negative/NAT-negative grafts (n = 6,321). Recipients of grafts from HCV antibody-positive/NAT-negative donors had similar survival whether recipients were HCV-negative patients (n = 191) or HCV-positive patients (n = 516), and their survival probabilities were similar to those of HCV-negative recipients (n = 6,321) receiving grafts from HCV antibody-negative/NAT-negative donors. Patient survival was lower (P = 0.049) when HCV-negative recipients (n = 210) received NAT-positive grafts compared with HCV-positive patients (n = 1,148) receiving NAT-positive grafts; however, when adjusted for recipient and donor characteristics, the difference was not significant.
HCV-negative recipients receiving HCV-positive liver grafts (NAT positive) have excellent 1-year survival outcomes.
将 HCV RNA 阳性肝脏移植到 HCV RNA 阴性受者中，其生存结果的数据有限。本研究的目的是确定 HCV RNA（核酸扩增检测 [NAT] 阳性）阳性的肝脏移植物移植到 HCV 阴性患者中时，是否存在移植物和患者生存的差异。
我们查询了 2014 年 1 月至 2018 年 12 月的 United Network for Organ Sharing 数据集，根据受者和供者的 HCV 抗体和 RNA 状态，将受者（N = 24724）分为 6 组。Cox 比例风险回归用于估计组间关系和 1 年 LT 后移植物或患者的生存情况。
研究期间，1358 例受者接受了 NAT 阳性的肝脏移植物。210 例受者 HCV 阴性。同期，707 例 HCV 抗体阳性但 NAT 阴性的移植物移植到 516 例 HCV 阳性和 191 例 HCV 阴性受者中。接受 NAT 阳性移植物的 HCV 阳性受者（n = 1148）与接受 HCV 抗体阴性/NAT 阴性移植物的受者（n = 6321）的生存情况无差异。HCV 抗体阳性/NAT 阴性供者的移植物受者无论受者为 HCV 阴性患者（n = 191）还是 HCV 阳性患者（n = 516），其生存概率均与接受 HCV 抗体阴性/NAT 阴性供者的 HCV 阴性受者（n = 6321）相似。与接受 HCV 阳性患者（n = 1148）的 NAT 阳性移植物相比，HCV 阴性受者（n = 210）接受 NAT 阳性移植物时的患者生存率较低（P = 0.049）；然而，在调整受者和供者特征后，差异无统计学意义。
接受 HCV 阳性肝脏移植物（NAT 阳性）的 HCV 阴性受者具有出色的 1 年生存率。
