Hepatitis C virus infection in liver allografts

Area of Science:

• Hepatology
• Transplant Surgery
• Virology

Background:

• Hepatitis C virus (HCV) infection is a primary indication for liver transplantation.
• De novo HCV infection occurs in 10% of liver transplant recipients, often via donor organs or transfusions.
• Recurrent HCV infection in the allograft is more common and does not resolve with native liver removal.

Purpose of the Study:

• To summarize the incidence, clinical course, and outcomes of recurrent HCV infection post-liver transplantation.
• To highlight the impact of recurrent HCV on liver allograft function and patient survival.

Main Methods:

• Review of patient data from liver transplant recipients at the University of Pittsburgh.
• Analysis of incidence rates of de novo and recurrent HCV infection.
• Assessment of clinical outcomes including hepatitis, cirrhosis, and graft survival.

Main Results:

• Recurrent HCV infection is frequent, with positive PCR tests in most post-transplant patients.
• Clinically significant hepatitis develops in 32-100% of patients worldwide, with 10% progressing to cirrhosis.
• Three-year graft survival is lower (68%) in HCV-infected recipients compared to other diseases (82%).

Conclusions:

• HCV infection persists and replicates in liver allografts under immunosuppression.
• Recurrent HCV infection significantly impacts graft survival and can lead to cirrhosis.
• HCV-associated cirrhosis remains a valid indication for re-transplantation.