@article {4092,
	title = {Increasing Utilization of Human T-Cell Lymphotropic Virus (+) Donors in Liver Transplantation: Is it Safe?},
	journal = {//Transplantation},
	volume = {87},
	year = {2009},
	month = {2009},
	pages = {1180 - 1190},
	publisher = {(1) Department of Surgery, Division of Transplantation, University of Louisville, Louisville, KY.(2) Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, Louisville, KY.},
	address = {(C) 2009 Lippincott Williams \& Wilkins, Inc.},
	abstract = {Background. Liver transplantation is the best treatment option for endstage liver disease. The human T-cell lymphotrophic virus (HTLV) has been associated with leukemia/lymphoma and progressive neurologic disease. There has, however, been an increased utilization of HTLV (+) grafts with little data available to support or discourage their use., Methods. We performed univariate and multivariate analyses related to graft and patient survival for recipients of HTLV (+) donors and compared them with recipients of HTLV (-) donors using the United Network for Organ Sharing database. Complete analysis of recipient and donor clinical and demographic factors was performed., Results. There were 81 adult recipients of HTLV (+) donors and 29,747 HTLV (-) donor recipients. HTLV (+) donors were more likely to be older, women, and black, with a higher average donor risk index and creatinine, and were more likely to be shared nationally. Recipients of HTLV (+) organs were at slightly elevated risk of graft failure (HR=1.39, 95\% CI 0.91-2.11) and death (HR=1.20, CI 0.71-2.02) relative to HTLV (-) donor recipients (P=0.12 and 0.5, respectively). The risk decreased after multivariate analysis - graft survival (HR=1.20, CI 0.79-1.83) and patient survival (HR=1.06, CI 0.63-1.79)., Conclusion. Our analysis reveals no statistically significant difference in graft or patient survival between recipients of HTLV (+) and (-) donors. Serious limitations of these data are that serologic testing for HTLV has a high false positive rate and that there was a short follow-up period. Until these issues are addressed, extreme caution should be exercised when using these organs., (C) 2009 Lippincott Williams \& Wilkins, Inc.},
	keywords = {Extended criteria donors, Human T-cell lymphotrophic virus, Liver Transplantation, UNOS data},
	isbn = {0041-1337},
	author = {Marvin, Michael and Brock, Guy and Kwarteng, Kwadwo and Nagubandi, Ravi and Ravindra, Kadiyala and Eng, Mary and Buell, Joseph}
}
