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Hepatitis C and liver transplantation

O Chazouilleres1, T L Wright

  • 1Hopital Saint-Antoine, Paris, France.

Journal of Gastroenterology and Hepatology
|July 1, 1995
PubMed
Summary

Hepatitis C virus (HCV) recurrence after liver transplant is common, affecting many recipients. While short-term survival is good, HCV negatively impacts long-term patient and graft survival, necessitating further study.

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Area of Science:

  • Hepatology
  • Transplantation Immunology
  • Virology

Background:

  • Chronic Hepatitis C virus (HCV) infection is a leading cause of end-stage liver disease and liver transplantation in North America and Europe.
  • HCV recurrence post-liver transplant is nearly universal, leading to viremia in many recipients, impacting graft and patient survival.
  • HCV can be acquired during transplantation through infected donors or transfused blood, posing a significant challenge in immunosuppressed patients.

Purpose of the Study:

  • To highlight the significance of Hepatitis C virus (HCV) in liver transplant recipients.
  • To discuss the implications of HCV recurrence on post-transplant outcomes.
  • To evaluate the impact of HCV infection on patient and graft survival rates.

Main Methods:

  • Review of existing literature on HCV in liver transplant recipients.
  • Analysis of histological findings in allografts, identifying HCV as a primary cause of hepatitis.
  • Utilizing HCV-RNA assays (e.g., b-DNA) to quantify viral load and assess recurrence.
  • Comparison of patient and graft survival rates between HCV-infected recipients and control groups.

Main Results:

  • HCV infection is a frequent cause of histological hepatitis in liver allografts (14-35%).
  • HCV recurrence post-transplant is observed in almost all pre-transplant infected patients, often underestimated by serological assays.
  • While short-term survival is comparable to non-viral liver disease, a recent study indicates HCV negatively impacts long-term patient and graft survival (P=0.001).

Conclusions:

  • Hepatitis C virus poses significant challenges in liver transplantation due to high recurrence rates and negative impact on long-term outcomes.
  • The magnitude of HCV infection in immunosuppressed recipients may be underestimated, with potential for a carrier state.
  • Despite negative impacts, short-term survival rates support continued transplantation for HCV-infected patients, though long-term consequences require further definition.

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