Liver transplantation for viral hepatitis.
Current one year survival rates of 73-83% for elective transplantation, and 55-70% for emergency transplantation, render liver transplantation an appropriate treatment for both end-stage chronic liver disease and acute liver failure. Candidates for transplantation for acute liver failure need to be identified as early as possible, and a model for selection using clinical criteria is described. Recurrent viral infection after transplantation is either a possible or proven problem in all patient subgroups, but the clearest manifestation is in patients with chronic hepatitis B infection. In our series of 29 patients surviving at least 60 days after transplantation, 41% died as a consequence of recurrent infection at 3-13 months. Delta virus infection appears to confer some protection in this regard, and the role of long-term immunoprophylaxis in preventing this serious complication remains to be established.
O'Grady
J G
JG
Liver Unit, King's College School of Medicine and Dentistry, London, UK.
Williams
R
R
D006506:Hepatitis A / Q000601:surgery*; D006509:Hepatitis B / Q000601:surgery*; D006526:Hepatitis C / Q000601:surgery*; D006525:Hepatitis, Viral, Human / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation