Hepatitis C positive recipients after liver transplant appear to perform slightly inferior compared to recipients who are HCV negative. Due to the shortage of organs and the availability of Hepatitis B treatment, hepatitis B core antibody positive donors are increasingly being used. Currently very little is known about their survival outcome. To examine the impact of hepatitis B core antibody positive liver allograft in recipients with hepatitis C viral infection. Between Jan 1997 to Feb 2003, all patients with hepatitis C viral infection who received hepatitis core antibody positive liver allograft were examined retrospectively from our institution. All patients were followed until January 2004. Mean follow-up of 27 + 19 (range 11- 84 months). All patients received Lamuvidine 100mg/day and postoperative 3 doses of HBIG 10,000 units as prophylaxis. 13 patients were found to be HCV positive by PCR and received hepatitis B core antibody positive livers from cadaver donors. There were 10 males and 3 females. Mean age was 50+4.6. Out of 13, two patients received core positive livers because they were critically ill, two had hepatocellular carcinoma and the remaining seven patients were positive for Hepatitis B core antibody. Survival: 4 patients died in the follow up period at 7.5,7.7,19.1 and 23.2 months post transplant from recurrent hepatitis C (n=2), recurrent HCC (n=1), and one patient from sepsis due to intrahepatic bile duct stricture with recurrent cholangitis. Retransplant: one patient underwent retransplant for HAT after 9 days. Actual current patient and graft survival at last follow up was 69.2% and 61.2% respectively. None of the patients had documented hepatitis B recurrence. Based on our results we feel hepatitis B core antibody positive donor grafts can be utilized in hepatitis C patients who are critically ill, and/or have hepatocellular carcinoma and/or have previous exposure to hepatitis B virus.