title: Risk factors for recurrence of hepatitis C after liver transplantation.
abstract: Recurrent hepatitis C is a frequent complication after liver transplantation for hepatitis C virus-related cirrhosis, but risk factors related to its development remain ill defined. Twenty-three patients receiving a primary liver graft for hepatitis C virus-related cirrhosis and with an assessable biopsy performed at least 6 months after liver transplantation were studied retrospectively. The end point of this study was to look for risk factors associated with the development of histologic hepatitis C in the graft. Thirty-six major variables were studied, and those reaching significance by univariate analysis were included in a multivariate analysis. Eighteen patients (78%) developed posttransplant hepatitis C. On univariate analysis, six variables showed significant predictive value: increased immunosuppression for treatment of acute rejection; pretransplant hepatocellular carcinoma; cumulative doses of prednisone at 3, 6, and 12 months after transplantation; and mean blood trough levels of cyclosporine in the first 6 months posttransplantation. On multivariate analysis, two variables retained independent statistical significance as predictors of hepatitis C recurrence, namely receipt of antirejection therapy (P = .0087) and lower mean cyclosporine levels in the first 6 months after transplantation (P = .0134). Therefore, recurrence of hepatitis C after liver transplantation seems to be at least partially related to posttransplantation immunosuppressive therapy.
authors.affiliation: Liver Unit, Clínica Universitaria de Navarra, Pamplona, Spain.
authors.forename: J I
authors.initials: JI
authors.lastname: Herrero
authors.forename: A
authors.initials: A
authors.lastname: de la Peña
authors.forename: J
authors.initials: J
authors.lastname: Quiroga
authors.forename: B
authors.initials: B
authors.lastname: Sangro
authors.forename: N
authors.initials: N
authors.lastname: García
authors.forename: I
authors.initials: I
authors.lastname: Sola
authors.forename: J A
authors.initials: JA
authors.lastname: Cienfuegos
authors.forename: M P
authors.initials: MP
authors.lastname: Civeira
authors.forename: J
authors.initials: J
authors.lastname: Prieto
mesh_terms: D000328:Adult; D001706:Biopsy; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000473:pathology / Q000517:prevention & control; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000201:enzymology / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016031:Liver Transplantation / Q000009:adverse effects* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000032:analysis; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D000637:Transaminases / Q000097:blood
chemical_list: D007166:Immunosuppressive Agents; D012367:RNA, Viral; D016572:Cyclosporine; D000637:Transaminases