Risk factors for recurrence of hepatitis C after liver transplantation.
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.
Herrero
J I
JI
Liver Unit, Clínica Universitaria de Navarra, Pamplona, Spain.
de la Peña
A
A
Quiroga
J
J
Sangro
B
B
García
N
N
Sola
I
I
Cienfuegos
J A
JA
Civeira
M P
MP
Prieto
J
J
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
D007166:Immunosuppressive Agents; D012367:RNA, Viral; D016572:Cyclosporine; D000637:Transaminases