Liver transplantation in hepatitis C. A Spanish multi-centre experience.
OBJECTIVE
The purpose of this retrospective survey was to determine the prevalence and outcome of hepatitis C virus (HCV) infection in cirrhotic patients undergoing liver transplantation (OLT) in Spain in 1992.


METHODS
Post-OLT HCV infection was defined by anti-HCV (second-generation ELISA) and/or PCR. Patients were divided into groups A (HCV-positive pre-OLT: n = 124, 46%) and B (HCV-negative pre-OLT: n = 145, 54%).


RESULTS
HCV infection was more prevalent in patients originally diagnosed as having non-A non-B cirrhosis (97%) and cryptogenic cirrhosis (79%) than in patients with cholestatic or metabolic diseases. Group A patients were older (53.3+/-7.9 versus 47.6+/-9.7; P< 0.05) and had a higher prevalence of hepatocellular carcinoma (22% versus 4%, P< 0.05). Post-OLT HCV infection was 99% in group A versus 4% in group B (P< 0.05). Histological hepatitis developed in 39% (66% in group A versus 14% in group B, P< 0.05) with similar follow-up. Chronic rejection occurred in 6% (3% in group A versus 8.5% in group B, P= 0.07). Retransplantation rate (overall 8%) and two-year patient survival did not differ between groups (79% versus 72%). Graft survival was higher in group A (74% versus 65% at 2 years, P= 0.04).


CONCLUSIONS
HCV-cirrhosis represented the most frequent indication for OLT in Spain in 1992. While HCV recurrence was universal, de novo acquisition was rare. HCV accounted for most post-OLT hepatitis (87%), but was not associated with chronic rejection, nor with a higher retransplantation rate. Patient survival was not different in HCV patients compared to a control group after a follow-up of 2-3 years. Therefore, at present, HCV-cirrhosis is an acceptable indication for OLT.
Prieto
M
M
Hospital Universitario La Fe, Valencia, Spain. mprieto@iname.com
Berenguer
M
M
Rimola
A
A
Loinaz
C
C
Barrios
C
C
Clemente
G
G
Figueras
J
J
Vargas
V
V
Casafont
F
F
Pons
J A
JA
Herrero
J I
JI
D000293:Adolescent; D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D008103:Liver Cirrhosis / Q000628:therapy* / Q000821:virology*; D008113:Liver Neoplasms / Q000453:epidemiology; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D011183:Postoperative Complications / Q000821:virology*; D012086:Reoperation; D012189:Retrospective Studies; D013030:Spain; D015996:Survival Rate; D016896:Treatment Outcome