Viral hepatitis in the liver transplant recipient

Understanding and management of HBV and HCV infection in the OLT recipient has evolved rapidly in the last decade. The spontaneous risk for viral recurrence after transplantation is high, but has been decreased effectively in hepatitis B-positive recipients with the use of HBIG and lamivudine. HCV recurrence as defined by histologic injury is almost universal, although graft or patient outcomes for the first 8 years after OLT do not appear to be limited by HCV serostatus. However, effective prophylactic regimens that alter the natural history of HCV reinfection do not currently exist, and with longer follow-up into the second decade, the prevalence of HCV-related graft failure is likely to increase.