[Viral hepatitis and liver transplantation]

Area of Science:

• Hepatology
• Transplantation Immunology
• Virology

Context:

• Chronic liver diseases, primarily viral hepatitis, are leading indications for liver transplantation.
• Graft reinfection by hepatitis viruses post-transplantation causes graft dysfunction, cirrhosis, and failure.
• Viral recurrence risk influences liver transplant eligibility and management strategies.

Purpose:

• To analyze the risk of hepatitis virus recurrence after liver transplantation.
• To evaluate the efficacy of prophylactic antiviral treatments in preventing recurrence.
• To inform clinical practice regarding transplant indications and post-operative management.

Summary:

• Hepatitis B virus (HBV) recurrence is higher in patients transplanted for HBV cirrhosis or fulminant hepatitis B, especially with active viral replication.
• Long-term anti-HBs immunoglobulin administration significantly lowers HBV recurrence and mortality, particularly in non-replicating patients.
• While short-to-medium term outcomes for hepatitis C virus (HCV) transplantation are favorable, high recurrence rates necessitate mandatory prevention protocols.

Impact:

• Optimized patient selection for liver transplantation based on viral replication status.
• Improved long-term graft survival through targeted antiviral prophylaxis.
• Development and implementation of standardized protocols to mitigate post-transplant viral hepatitis recurrence.