[Viral hepatitis and liver transplantation]

Chronic liver diseases due to hepatitis viruses are the main indication for liver transplantation. Recurrence of viral infection on the liver graft is responsible for the occurrence of chronic hepatitis, liver cirrhosis, or liver failure. The risk of viral recurrence may influence the indications for liver transplantation. The risk of viral B recurrence is higher in patients transplanted for viral B liver cirrhosis than for viral B-delta liver cirrhosis, and for fulminant hepatitis B. This risk is higher in patients with active viral B replication at time of transplantation. Long-term administration of anti-HBs immunoglobulins reduces significantly the HBV recurrence rate and the related mortality, especially in patients without active HBV replication at transplantation. Middle-term results for patients transplanted for viral C related liver cirrhosis are good, but the recurrence rate of HCV infection is high. Protocols of prevention of HCV recurrence after transplantation are mandatory.