Hepatitis C recurrence after liver transplantation.
Hepatitis C-related cirrhosis is the major indication for liver transplantation (LT). This disease recurs histologically in nearly all the HCV-infected patients during the first postoperative year. Chronic hepatitis C evolves to cirrhosis in 20% of the cases within 5 years after LT. However, the 5-year survival for a HCV-infected recipient is still comparable to that of a patient grafted for another indication; it will become worse later. High viremia after LT is associated with a more severe liver recurrent disease. The influence of viral genotype remains controversial. The impact of the type of immunosuppression on HCV recurrence is unclear. Steroids, that increase viremia, might have a deleterious effect on the outcome of chronic HCV-disease after LT. Antiviral combined therapy (Interferon + Ribavirin) soon after transplantation, before disease recurrence, is probably the best treatment at the present time; this remains still unproven. Retransplantation for HCV recurrent cirrhosis allows a 60% survival at 1 year.
Bourgeois
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Medicosurgical Department of Gastroenterology, Hopital Erasme, ULB, Brussels.
D000998:Antiviral Agents / Q000627:therapeutic use; D006526:Hepatitis C / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016031:Liver Transplantation; D012008:Recurrence; D014766:Viremia
D000998:Antiviral Agents; D007166:Immunosuppressive Agents