肝移植（LT）为患有并发症和肝细胞癌的肝硬化患者提供了挽救生命的选择。尽管每年进行的肝移植数量不断增加，但由于供体器官供应与需求之间的不平衡，导致等待名单上的肝移植候选者数量保持不变，从而增加了等待时间和死亡率。活体肝移植在增加供体库和缩短 LT 候选人的候补时间方面发挥了巨大作用。尽管如此，可以实施进一步的策略来增加已故捐献者 LT 中的潜在捐献者库，例如降低器官丢弃率。使用丙型肝炎病毒（HCV）血清阳性的肝移植物是扩大的供体器官标准之一。由于最大限度地利用 HCV 阴性受体的 HCV 阳性器官，预计每年将增加数百例移植手术。直接作用抗病毒疗法的功效彻底改变了 HCV 感染的治疗以及 HCV 血清阳性供体在移植中的使用。美国移植学会建议不要将 HCV 感染的肝脏捐献者 (D ) 移植到 HCV 阴性的受者 (R-) 中，除非符合机构审查委员会批准的研究规则，并且充分知情同意与此类移植相关的知识差距。正确选择接受 HCV 感染移植物移植的患者并确认他们在需要时能够获得直接作用的抗病毒药物非常重要。需要国家和国际共识来规范这一过程，以确保最大的利益和最少的不良事件。©作者2024。由百事登出版集团有限公司出版。保留所有权利。

Liver transplantation (LT) provides a life-saving option for cirrhotic patients with complications and hepatocellular carcinoma. Despite the increasing number of liver transplants performed each year, the number of LT candidates on the waitlist remains unchanged due to an imbalance between donor organ supply and the demand which increases the waitlist time and mortality. Living donor liver transplant had a great role in increasing the donor pool and shortened waitlist time for LT candidates. Nevertheless, further strategies can be implemented to increase the pool of potential donors in deceased donor LT, such as reducing the rate of organ discards. Utilizing hepatitis C virus (HCV) seropositive liver grafts is one of the expanded donor organ criteria. A yearly increase of hundreds of transplants is anticipated as a result of maximizing the utilization of HCV-positive organs for HCV-negative recipients. Direct-acting antiviral therapy's efficacy has revolutionized the treatment of HCV infection and the use of HCV-seropositive donors in transplantation. The American Society of Transplantation advises against performing transplants from HCV-infected liver donors (D+) into HCV-negative recipient (R-) unless under Institutional Review Board-approved study rules and with full informed consent of the knowledge gaps associated with such transplants. Proper selection of patients to be transplanted with HCV-infected grafts and confirming their access to direct-acting antivirals if needed is important. National and international consensuses are needed to regulate this process to ensure the maximum benefit and the least adverse events.©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.