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Updated: May 13, 2026
Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt
Published on: May 7, 2015
Incidence, prevalence, and clinical course of hepatitis C following liver transplantation
G Shah1, A J Demetris, J S Gavaler
1Department of Surgery, University of Pittsburgh School of Medicine, Pennsylvania.
Insights
Hepatitis C virus (HCV) can cause hepatitis after liver transplants. This study found posttransplant hepatitis in 13.8% of recipients, with a low rate of progression to chronic active hepatitis.
Area of Science:
- Hepatology
- Virology
- Transplant Immunology
Background:
- Hepatitis C virus (HCV) is a known cause of posttransfusion hepatitis.
- The behavior of HCV in liver transplant recipients remains poorly understood, including incidence, timing, and clinical outcomes.
- Non-A, non-B (NANB) hepatitis is a significant concern in the post-transplant setting.
Purpose of the Study:
- To investigate the incidence, timing, and clinical course of HCV-positive hepatitis in liver transplant recipients.
- To determine the prevalence of anti-HCV positivity in donor-recipient pairs.
- To assess the rate of seroconversion and progression to chronic active hepatitis post-transplant.
Main Methods:
- Analysis of 317 donor-recipient liver transplant pairs, categorized by pretransplant HCV antibody status.
- Grouping into four categories: recipient negative/donor negative, recipient positive/donor negative, recipient negative/donor positive, and recipient positive/donor positive.
- Examination of biopsy findings to identify histologic hepatitis and assess its progression.
Main Results:
- Prevalence of anti-HCV positivity in recipients was 13.6%, with a seroconversion rate of 9.2%.
- Histologic hepatitis, attributed to NANB hepatitis, occurred in 13.8% of recipients.
- Progression to histologic chronic active hepatitis was observed in 1.6% of cases, with no progression to cirrhosis noted.
Conclusions:
- Posttransplant NANB hepatitis affects 13.8% of liver recipients.
- A minority (20%) of these cases were anti-HCV positive pre-transplant.
- Progression to chronic active hepatitis is infrequent, occurring in 1.6% over 1-5 years.
Abstract:
Hepatitis C virus (HCV) is the agent responsible for posttransfusion hepatitis. The incidence, timing, and clinical course of HCV positive hepatitis in liver transplant recipients are unknown. Three hundred and seventeen donor-recipient liver transplant pairs were grouped on the basis of their pretransplant HCV antibody status. The biopsy findings were examined. Four distinct groups were identified on the basis of HCV serology: group I, both were negative; group II, donor was negative and recipient was positive; group III, donor was positive and recipient was negative; group IV, both were positive. The prevalence of anti-HCV positivity in recipients was 13.6%. The rate of seroconversion was 9.2%. Histologic hepatitis not ascribable to any specific cause other than non-A, non-B (NANB) hepatitis occurred in 13.8%. The incidence of histologic chronic active hepatitis was 1.6%, and none progressed to cirrhosis. The concordance rate for a positive anti-HCV serology and NANB hepatitis was 2.8%. Of the 35 patients (group II and IV) with positive anti-HCV serology pretransplant, only 17 were positive posttransplantation. Based on these data it can be concluded that posttransplant NANB hepatitis occurred in 13.8% of liver recipients. Twenty percent of these were anti-HCV positive. Progression to histologic chronic active hepatitis occurs over a period of 1-5 years in 1.6% of cases.
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