[The recurrence of hepatitic C in orthotopic liver transplantation].
BACKGROUND
This study is a review of hepatitis C recurrence in patients undergoing an orthotopic liver transplantation (OLT); to verify how many patients HCV-positive before OLT confirm a persistent viremia after OLT and how many with viremia show hepatitis histological evidence.


METHODS
Thirty consecutive patients, 24 males, median age 52.5 underwent OLT for posthepatitic C cirrhosis since January 1993 in the "Transplantation Center" of Genoa. Serology included anti-HCV search, HCV-RNA and HBV-DNA determinations, biopses were performed in the transplanted liver within the month after operation, subsequently at every hepatic enzymes increase.


RESULTS
Twenty-one patients are currently alive, median follow-up of 14.5 months. Before OLT anti-HCV antibodies search was positive in all the patients while the HCV-RNA by PCR resulted positive in 17 and negative in 4. Before OLT the HBV-DNA in patients with associated hepatitis B was negative. After OLT 5 patients, of the 17 HCV-RNA positive before OLT, have turned negative then all became again positive from 6 to 12 months later; 2 of the 4 patients HCV-RNA negative before OLT have turned positive, and remained still negative two with hepatitis C associated with hepatitis B. Although viral replication was present in 95% of the patients, clinical and histological evidence of recurrence was ascertained only in 29%.


CONCLUSIONS
It should be noted that the hepatitis histological picture doesn't correspond to a severe worsening of clinical conditions, an evolution justifying transplantation. The long-term results of this therapeutic choice are still uncertain due to the high incidence of recurrences.
Germi
M R
MR
Istituto di Anestesiologia e Rianimazione, Università degli Studi, Genova.
Pellicci
R
R
Testa
R
R
Ardizzone
G
G
Lemut
F
F
Pozzo
A
A
Siani
C
C
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012008:Recurrence
La recidiva di epatite C nel trapianto ortotopico di fegato (OLT).