Clinical recurrence of hepatitis A following liver transplantation for acute liver failure.
This paper documents clinically significant recurrence of hepatitis A virus (HAV) infection in a 63-year-old man transplanted for HAV-related acute liver failure. HAV RNA was documented in the explant and, following early clearance from the blood and graft, was again detected in post-operative biopsies at the time of an acute hepatic illness. Although the clinical and biochemical abnormalities resolved completely, the patient had a second episode of graft dysfunction 6 months later and investigations revealed hepatitis C virus (HCV)-related chronic active hepatitis consistent with acquired HCV infection at the time of transplantation. The possible interaction with hepatitis A may have delayed the appearance of hepatitis C. Administration of HAV immunoglobulin at the time of transplantation should be considered in all cases of HAV-related fulminant hepatic failure.
Gane
E
E
Institute of Liver Studies, King's College Hospital, London, United Kingdom.
Sallie
R
R
Saleh
M
M
Portmann
B
B
Williams
R
R
D001483:Base Sequence; D001706:Biopsy; D006084:Graft Rejection; D006501:Hepatic Encephalopathy / Q000601:surgery; D006506:Hepatitis A / Q000473:pathology / Q000601:surgery / Q000821:virology*; D006526:Hepatitis C / Q000473:pathology; D006521:Hepatitis, Chronic / Q000473:pathology; D006507:Hepatovirus / Q000302:isolation & purification*; D006801:Humans; D008099:Liver / Q000473:pathology / Q000821:virology*; D017114:Liver Failure, Acute / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction / Q000379:methods; D011183:Postoperative Complications; D012367:RNA, Viral / Q000032:analysis / Q000097:blood; D012008:Recurrence
D012367:RNA, Viral