Mild donor liver steatosis has no impact on hepatitis C virus fibrosis progression following liver transplantation

Background: This study examines the impact of donor liver macrovesicular steatosis on recurrence of hepatitis C virus ( HCV) disease after liver transplantation. Methods: Between 1998 and 2004, 113 patients underwent liver transplantation for HCV- related cirrhosis. Time to histologic recurrence ( fibrosis score >= 2) was the primary endpoint of the study. Recurrence was graded according to the system of Ludwig and Batts. A Cox's proportional hazard regression model was used to analyse the association between donor liver steatosis and HCV recurrence. Results: Recurrencefree survival for patients who received steatotic grafts was 82% and 47% at 1 and 4 years, respectively, and 81% and 52% for patients who received a non- steatotic liver. Donor macrovesicular steatosis ( 5 - 45%) was found to have no impact on HCV recurrence ( P= 0.47). Donor age ( P = 0.02) and cold ischaemia time ( P= 0.01) were found to increase the relative risk of HCV recurrence. The estimated risk of HCV recurrence increased by 23% for every 10- year increase in donor age. Similarly the risk of recurrence increased by 13% for every 1- h increase in cold ischaemia time. Conclusion: Mild- moderate donor liver macrovesicular steatosis has no impact on HCV recurrence after liver transplantation for HCV- related cirrhosis. Cold ischaemia time and donor age increased the likelihood of HCV recurrence.