BackgroundThe use of HCV-positive livers for HCV-positive recipients is becoming more common. Our aim is to evaluate long-term outcomes in liver transplant recipients transplanted with HCV antibody-positive organs.MethodsFrom the Scientific Registry of Transplant Recipients (1995â2013), we selected all adult liver transplant recipients with HCV, and cross-sectionally compared long-term graft loss and mortality rates between those who were transplanted from HCV antibody-positive (HCV+) vs. HCV antibody-negative donors.ResultsWe included 33,668 HCV+ liver transplant recipients (54.0â±â7.7 years old, 74.1% male, 71.0% white, 23.6% with liver malignancy). Of those, 5.7% (Nâ=â1930) were transplanted from HCV+ donors; the proportion gradually increased from 2.9% in 1995 to 9.4% in 2013. Patients who were transplanted from HCV+ positive donors were more likely to be discharged alive after transplantation (95.4% vs. 93.9%, pâ=â0.006), but this difference was completely accounted for by a greater proportion of HCV+ donors in more recent study years (pâ=â0.10 after adjustment for the transplant year). After transplantation, both mortality in HCV patients transplanted from HCV+ donors (12.5% in 1 year, 24.2% in 3 years, 33.0% in 5 years) and the graft loss rate (2.2% in 1 year, 4.8% in 3 years, 7.5% in 5 years) were similar to those in HCV patients transplanted from HCV-negative donors (all pâ>â0.05).ConclusionsOver the past two decades, the use of HCV+ organs for liver transplantation has tripled. Despite this, the long-term outcomes of HCV+ liver transplant recipients transplanted from HCV+ donors were not different from those who were transplanted with HCV-negative organs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12876-016-0551-z) contains supplementary material, which is available to authorized users.