Liver transplantation for alcoholic liver disease with or without hepatitis C.
Alcoholic cirrhosis with or without hepatitis C is a common indication for liver transplantation (LT). Comparative post-LT data for the 2 groups are not available. Our aim is to compare the clinicopathologic features of patients with alcoholic liver disease (ETOH) and ETOH/HCV at the time of and after LT and to determine the impact of concomitant hepatitis C virus (HCV) on ETOH patients undergoing LT. A comparative clinical and pathologic analysis at LT and after LT was performed for 56 patients with ETOH and 32 patients with ETOH/HCV. All 88 had cirrhosis at LT. Other native liver features for ETOH and ETOH/HCV, respectively, were: >2+ inflammation 50/56 and 26/32, Mallory's hyalin 12/56 and 6/32, steatosis 9/56 and 7/32, large cell dysplasia 12/56 and 6/32, hepatoma 4/56 and 4/32, iron deposition 24/56 and 12/32; none was statistically significant. The post-LT findings for ETOH and ETOH/HCV were as follows: 1-year survival 93% and 97%; alive 36/56 (419-4,348 days) and 27/32 (488-5,516 days); deaths 20/56 and 5/32; ETOH recurrence 5/56 (all alive) and 3/32 (1 dead); post-LT HCV 4/56 (acquired) and 22/32 (recurrent). Native liver histology in ETOH and ETOH/HCV patients was similar. Post-LT HCV recurrence was common (69%) in ETOH/HCV patients but resulted in death in only 6%. Post-LT ETOH recurrence was uncommon (9%) and progression to liver failure was rare (1.1%). Post-LT outcome for ETOH was excellent, and concomitant HCV did not affect survival.
Goldar-Najafi
Atoussa
A
Department of Pathology, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston MA, USA.
Gordon
Fredric D
FD
Lewis
W David
WD
Pomfret
Elizabeth
E
Pomposelli
James J
JJ
Jenkins
Roger L
RL
Khettry
Urmila
U
D000328:Adult; D000368:Aged; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D006526:Hepatitis C / Q000150:complications / Q000601:surgery*; D018937:Hepatitis C Antibodies / Q000032:analysis; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications / Q000401:mortality / Q000601:surgery*; D017093:Liver Failure / Q000150:complications / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications; D012367:RNA, Viral / Q000032:analysis; D016019:Survival Analysis; D015996:Survival Rate
D018937:Hepatitis C Antibodies; D012367:RNA, Viral