title: [Orthotopic liver transplantation in hepatic cirrhosis: on the problem of infection of the transplant with persistent hepatitis viruses].
abstract: 269 orthotopic liver transplantations (OLT) were performed in 253 patients at our institution from September 1988 to May 1992. 121 patients had end-stage cirrhosis secondary to viral hepatitis type B, delta, or type non-A non-B and C respectively. Reinfection of the graft by persistent viruses is a potential complication in these cases. Passive immunization with anti-HBs hyperimmunoglobulin (HIg) can prevent clinically relevant reinfection of the graft in patients with hepatitis B virus (HBV) infection and low replication rates. Patients with high replication rates will rarely benefit from OLT. Patients with hepatitis delta virus (HDV) infection usually experience HDV reinfection of the graft with subsequent chronic hepatitis although prophylaxis with anti-HBs-HIg was performed. Treatment with interferon alpha had no apparent effect on the incidence of graft reinfection with HBV in this series, but the replication rate of HDV was reduced. Persistent hepatitis C viruses (HCV) usually infect the graft; this was demonstrated in 17 patients by means of the polymerase chain reaction. HCV infection usually causes a mild form of acute hepatitis with transition to a chronic course. Therefore the significance of persistent viral infection lies in the potential for chronic hepatitis in the transplanted organ rather than in the danger of acute injury of the allograft.
authors.affiliation: Abteilung für Innere Medizin, Universitätsklinikum Rudolf Virchow, Freie Universität Berlin.
authors.forename: U
authors.initials: U
authors.lastname: Hopf
authors.forename: P
authors.initials: P
authors.lastname: Neuhaus
authors.forename: V
authors.initials: V
authors.lastname: König
authors.forename: J
authors.initials: J
authors.lastname: Bauditz
authors.forename: S
authors.initials: S
authors.lastname: Küther
authors.forename: C A
authors.initials: CA
authors.lastname: Schmidt
authors.forename: R
authors.initials: R
authors.lastname: Steffen
authors.forename: G
authors.initials: G
authors.lastname: Blumhardt
authors.forename: W O
authors.initials: WO
authors.lastname: Bechstein
authors.forename: R
authors.initials: R
authors.lastname: Neuhaus
mesh_terms: D001707:Biopsy, Needle; D005455:Fluorescent Antibody Technique; D006501:Hepatic Encephalopathy / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D006509:Hepatitis B / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D006526:Hepatitis C / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D003699:Hepatitis D / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D006521:Hepatitis, Chronic / Q000209:etiology / Q000517:prevention & control / Q000601:surgery*; D006801:Humans; D007124:Immunoenzyme Techniques; D007279:Injections, Subcutaneous; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000209:etiology / Q000517:prevention & control / Q000601:surgery*; D016031:Liver Transplantation; D010865:Pilot Projects; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D011994:Recombinant Proteins; D012008:Recurrence; D012307:Risk Factors; D015163:Superinfection / Q000209:etiology / Q000517:prevention & control / Q000601:surgery
chemical_list: D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins
vernacular_title: Orthotope Lebertransplantation bei hepatitischer Zirrhose: Zur Problematik der Infektion des Transplantates mit persistierenden Hepatitisviren.