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Liver transplantation for hepatitis B and C virus-related cirrhosis: mid-term results

T M Manzia1, D Di Paolo, D Sforza

  • 1Transplant Unit, Department of Surgery, University of Rome Tor Vergata, Rome, Italy. tomanzia@libero.it

Transplantation Proceedings
|June 11, 2010
PubMed

Insights

Hepatitis C virus (HCV) and Hepatitis B virus (HBV) coinfection in liver transplant recipients shows promising midterm outcomes. Patients with HBV-HCV cirrhosis had slower fibrosis progression compared to HCV-only cases.

Area of Science:

  • Hepatology
  • Transplantation Immunology
  • Virology

Background:

  • Hepatitis C virus (HCV) recurrence post-liver transplant is common, leading to cirrhosis in 30% of cases.
  • Understanding outcomes for liver transplant recipients with concomitant Hepatitis B virus (HBV) infection is crucial.

Purpose of the Study:

  • To retrospectively analyze midterm outcomes of liver transplant recipients with HBV-HCV coinfection.
  • To compare fibrosis progression rates between HBV-HCV coinfected and HCV-monoinfected patients.

Main Methods:

  • Retrospective analysis of 350 liver transplant recipients (April 1992-December 2008).
  • Focus on 20 patients transplanted for HBV-HCV cirrhosis.
  • Kaplan-Meier survival analysis and Ishak scoring for chronic hepatitis.
  • Yearly protocol liver biopsies for fibrosis assessment.

Main Results:

  • At a median follow-up of 68.4 months, 1- and 5-year patient/graft survival rates were 80% and 70%.
  • The 5-year fibrosis progression rate was 0.17 +/- 0.08 units.
  • One patient developed cirrhosis due to lamivudine-resistant HBV recurrence.
  • HBV-HCV coinfected patients exhibited a lower fibrosis progression rate than HCV-monoinfected patients.

Conclusions:

  • Liver transplantation for HBV-HCV coinfection demonstrates acceptable midterm survival rates.
  • Coinfection with HBV may be associated with a slower rate of fibrosis progression post-transplant compared to HCV monoinfection.
  • Monitoring for viral recurrence, especially lamivudine-resistant HBV, is essential.

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