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Early studies found little evidence that either short-term graft or patient survival was affected by transplanting HCV+ grafts instead of HCV negative (HCV?) grafts into HCV+ patients [4�C10]. A 10-year follow-up from a single-center study found similar long-term (8?years) outcomes and severe HCV http://www.selleckchem.com/products/ly2157299.html recurrence rates in HCV+ recipients of HCV+ and HCV? grafts [11], although there was a higher rate of HCV recurrence defined by histology in the HCV+ donor group and their numbers of long-term survivors were small. During the early years of liver transplantation in the USA, studies utilized the UNOS database to analyze the effect of HCV donor status on a larger scale. Marroquin et?al. followed 2923 liver transplants in HCV+ recipients performed from April 1994 to June 1997, 96 of those involving HCV+ donors. It was concluded that similar graft survival and equivalent http://www.selleck.cn/products/BIBW2992.html if not increased patient survival rates were evident in the HCV+ donor compared with the HCV? donor for HCV+ recipients [12]. Velidedeoglu, et?al., performed the largest study to date, following 5243 HCV+ recipients, 190 of which had an HCV+ donor, from January 1995 to December 1999. Three-year graft survival rates were similar among both patient populations [13]. Other more recent small trials have continued to support the notion of using HCV+ grafts in HCV+ recipients without major clinical detriment [14,15]. The purpose of this study is to investigate the long-term effect of liver transplantation using HCV+ donors including data from the modern era of organ allocation, transplantation and immunosuppression. The Organ Procurement and Transplantation Network (OPTN) liver transplant dataset was analyzed for all adult (age?��?18), non-status 1, liver transplantations occurring in the U.S from the initial time when hepatitis C status was reported to the OPTN in April 1994 through February 6, 2008. Recipients with more than 1?year of follow-up were included in the analysis. Recipient and donor factors known from the literature or clinical practice to influence mortality after liver transplantation were analyzed between those patients receiving HCV? allografts and compared with those receiving HCV+ allografts. Factors compared between groups included donor and recipient gender, age, and race. Recipient medical factors http://www.selleckchem.com/products/z-vad-fmk.html included hepatitis C status, pretransplant diabetes mellitus, presence of hepatocellular carcinoma (HCC), and retransplantation status. Donor and procedural medical factors included cause of death, organ sharing type (local, regional, national), and cold ischemia time. Because values for cold ischemia time were missing in 6500 records (11.55%), category mean was substituted for the missing values of this variable. All other variables were missing in