Background: HCC is commonly associated with viral infections such as HCV & HBV.

Aim: To determine whether Hepatitis viral status has impact on survival after OLT for HCC.

Methods: We reviewed OLTs for HCC reported to UNOS between 2002 & 2013 after excluding all patients transplanted out of Milan criteria .We classified HCC patients into 4 groups according to Hepatitis viral status and compared survival outcomes between groups.

Results: 11,928 patients were transplanted for HCC, of which 11,555 were within Milan. 6869 patients (65%) were HCV+, 788 patients (7%) were HBV+, 184 patients were both HCV+ & HBV+, and 2771 patients (26%) were not infected. HCV patients were significantly older than HBV patients (mean age 57 vs 56.1, p<0.001) & younger than patients with no Hepatitis infection (mean age 59.5, p<0.001). Most of the HBV patients were Asians (60%), while most of the patients in the other 3 groups were Caucasians (69.8%). DM was more common in no Hepatitis (37%) compared to HCV+ (23%;p<0.001), HBV+ (23%;p<0.001) & patients with both infections (26%; p=0.003). HBV patients had a lower BMI than HCV patients (mean BMI 25.8 vs 28.3, p<0.001). HBV patients had higher AFP than HCV patients (P<0.001) who had higher AFP than patients with no Hepatitis infection (P<0.001). HCV patients had a higher MELD at listing than HBV patients (P<0.001). No differences were observed in tumor burden ( number of tumors, total & largest tumor diameter) within the groups. The 5 year post OLT survival was lowest (57%) in HCV patients & in patients with both HBV & HCV infections (59%; p=0.633, vs HCV+ alone). In contradistinction HBV patients had higher 5 year survival rates 74% (p<0.001 vs HCV+). Intermediate results (64% 5 yr. survival) were seen in patients with no hepatitis infection (p<0.001, vs HCV+)

Conclusion: HCV viral infections negatively impact survival of patients undergoing OLT for HCC. HBV infected patients with HCC have excellent survival rates after OLT.

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