The single largest group in the United States that require liver transplants are those who are in the final stages of liver disease based on long term infection by the Hepatitis C virus. The problem is that even after a transplant Hepatitis C, also known as HCV, is known to recur in up to eighty eight percent of all patients.
Unlike the diseases normal progression, where cirrhosis of the liver can take at least twenty years to become a problem, after a liver transplant it can reoccur in as little as five years and sadly when it does it comes back with a fury.
The type of liver that is used in the transplant is one of the factors that can influence how quickly the cirrhosis returns. If the liver transplant is done with a living donor that greatly influences the return of the disease. A living donor liver transplant is one in which a proper match is made with someone still living, often a close relative, and then only a piece of the donors liver is taken and transplanted.
This can be done because the liver is the only human organ that can regenerate itself. The other alternative is for the more common cadeveric organ transplants where the organ comes from someone who has passed away and their organs are donated by family or because they have an organ donor card.
There are theories, but so far they are only theories, on the reason for these differences.
Some studies have shown that the drug therapies affect the organs differently. Others claim it might be the directly related to the health of the living relative who donated the organ or the age and race of the both transplant recipient and the donor. The overall health of the recipient is always a factor.
Since there is strong proof that the living donor liver transplants do not have as good long-term results this procedure has sparked a controversy in the medical community. The concerns are that this major surgical procedure seems to give only a year or two of good health.
Although a study conducted on patients who had received a living donor liver transplant found them to overall be younger, thinner, not in ICU at the time of transplant and more likely to have lesser end stage symptoms, they still found that they were forty four percent more likely to run the risk of transplant failure than those who had a transplant from someone who had passed away. This difference continues to be researched.
These findings have stirred up the medical community. Transplanted organs are not readily available and the surgeons do not want to see the necessity of a person going through more than one transplant in their lifetime. With the strong scientific evidence that Hepatitis C will frequently reoccur within five years of a transplant the medical community are trying to rationalize whether HCV sufferers are the best candidates to have liver transplants. While the sufferers are reassuring them they are.