Hepatitis C and Liver Transplant Illustration

Hepatitis C and Liver Transplants: Is Using AB-Positive Donor Livers a Safe Bet?

Jordan Keane in Health & Wellness June 2025 • 4 min read.

"Explore the groundbreaking research on using Hepatitis C antibody-positive donor livers in non-viremic liver transplant recipients, balancing the critical need for organs with patient safety."

The demand for liver transplants far exceeds the available supply, creating a critical shortage that impacts countless lives. In 2017 alone, over 8,000 liver transplants were performed, yet more than 13,000 patients remained on the waiting list, highlighting the urgent need for innovative solutions.

One potential avenue for expanding the donor pool involves utilizing livers from donors who are Hepatitis C antibody-positive but have no detectable virus (HCV Ab+/NAT-). These organs were often considered unsuitable in the past, but recent advancements in antiviral treatments have prompted a re-evaluation of their use.

A new study published in the Journal of the American College of Surgeons investigates the safety and efficacy of transplanting HCV Ab+/NAT- livers into non-viremic recipients. By comparing outcomes with a control group receiving livers from increased-risk donors without Hepatitis C, the researchers shed light on the potential of this approach to alleviate the organ shortage while maintaining acceptable patient safety standards.

Understanding the Study: Balancing Risks and Benefits of Hepatitis C Transplants

Hepatitis C and Liver Transplant Illustration

This research, conducted at the University of Cincinnati Medical Center, tracked 55 patients who received HCV Ab+/NAT- livers. The study aimed to determine the rate of Hepatitis C transmission, as well as assess overall graft function, complications, and survival rates. A comparison group of 57 patients receiving livers from PHS increased-risk donors (IRD) without Hepatitis C was used to benchmark the results.

Here's a breakdown of the key findings:

Transmission Rate: The study revealed a 9% transmission rate of Hepatitis C from the HCV Ab+/NAT- donor livers to the recipients.
Treatment Success: Of those who contracted Hepatitis C, 80% achieved viral eradication through antiviral treatment.
No Late Conversions: Encouragingly, no patients who initially tested negative for Hepatitis C at 3 months post-transplant later seroconverted at the 1-year mark.
Comparable Outcomes: The recipients of HCV Ab+/NAT- livers experienced similar graft and renal function, complication rates, and survival rates compared to the control group who received livers from PHS IRD HCV Ab-/NAT- donors.

These results suggest that utilizing HCV Ab+/NAT- donor livers could be a viable strategy for expanding the donor pool without compromising patient outcomes, provided that appropriate monitoring and treatment protocols are in place.

The Future of Liver Transplantation: Expanding the Donor Pool Safely

As the study authors conclude, utilizing HCV Ab+/NAT- donor livers represents a promising approach to address the critical shortage of organs for transplantation. With effective antiviral therapies readily available, the risk of transmission can be effectively managed. By carefully considering the potential benefits and risks, medical professionals can make informed decisions to expand the donor pool and save more lives.

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Everything You Need To Know

What is the main challenge addressed by the research on Hepatitis C positive liver transplants?

The primary challenge is the critical shortage of donor organs for liver transplants. The demand for livers far exceeds the supply, leaving many patients on waiting lists. This research investigates a potential solution to increase the donor pool by using livers from donors who are Hepatitis C antibody-positive but have no detectable virus (HCV Ab+/NAT-).

What are the risks associated with using Hepatitis C antibody-positive livers, and how is this risk mitigated?

The main risk is the potential transmission of Hepatitis C to the recipient. The study found a 9% transmission rate. However, this risk is mitigated by the availability of effective antiviral treatments. In the study, 80% of patients who contracted Hepatitis C achieved viral eradication through antiviral treatment. Moreover, the study showed no late conversions, meaning no patients who were initially negative for Hepatitis C later developed the infection at the 1-year mark. This is why the monitoring is so important.

How does the outcome of transplanting HCV Ab+/NAT- livers compare to using livers from other increased-risk donors?

The research compared outcomes of patients receiving HCV Ab+/NAT- livers to a control group who received livers from PHS increased-risk donors (IRD) without Hepatitis C (HCV Ab-/NAT-). The study found that recipients of HCV Ab+/NAT- livers experienced similar graft and renal function, complication rates, and survival rates compared to the control group. This suggests that, with appropriate monitoring and treatment, using HCV Ab+/NAT- livers does not significantly compromise patient outcomes.

Can you explain the significance of the study's findings on Hepatitis C transmission and treatment success?

The study's findings are significant because they demonstrate that Hepatitis C transmission from HCV Ab+/NAT- donor livers is manageable. While a 9% transmission rate was observed, the fact that 80% of those infected achieved viral eradication through antiviral treatment is highly encouraging. Furthermore, the absence of late conversions at the 1-year mark indicates that early detection and treatment protocols are effective in preventing long-term Hepatitis C infection in recipients. This supports the approach of expanding the donor pool with HCV Ab+/NAT- livers, provided that recipients are closely monitored and treated promptly if the virus is detected. Without effective treatment options and monitoring, the risk would be substantially higher, diminishing the benefits.

In the context of liver transplantation, what does the study suggest about the future of expanding the donor pool, and what factors are crucial for success?

The study suggests that utilizing HCV Ab+/NAT- donor livers is a promising approach to expand the donor pool and address the organ shortage. Key factors for success include the availability of effective antiviral therapies and implementing appropriate monitoring and treatment protocols. The research emphasizes the importance of balancing the potential benefits of increasing the donor pool with the risks of Hepatitis C transmission. Careful consideration and decision-making by medical professionals will be essential to ensuring patient safety and maximizing the number of lives saved through liver transplantation, which is currently limited by the lack of available organs.