Hepatitis C virus recurrence in living donor liver transplant recipients.
Recurrence of hepatitis C virus (HCV) after liver transplantation (LT) is a universal phenomenon. Recent reports have suggested an earlier and more aggressive recurrence in the living donor liver transplant (LDLT) population. The aim of this study was to compare the histological recurrence of HCV after LDLT versus deceased donor transplantation (DDT). Twenty-nine patients underwent LT for HCV-related end-stage liver disease at our institution between April 2001 and March 2003 (42 months). Twenty patients underwent DDT, and nine patients LDLT. Laboratory data were collected on a weekly to biweekly basis and HCV PCR was performed before LT and 3-4 months and yearly post-LT. Liver biopsies were performed as needed and per institutional protocol at 7 days, at 4 months, and yearly thereafter. All biopsies were evaluated by a single pathologist and scored for rejection (Banff score) and chronic hepatitis (Ishak score system). The predominant genotype in the DDT and LDLT groups was genotype 1 (DDT = 70%, LDLT = 79%). HCV RNA titers pre-LT and 3-4 months after LT did not differ. The incidence of rejection was higher in the DDT group (P < 0.05). There was a trend toward improved Ishak stage and grade in the LDLT group at 4 and 12 months post-LT, however, this trend did not reach statistical significance. No histological difference in the recurrence or severity rate was observed at 4 or 12 months post-LT in the DDT group vs. the LDLT group.
Division of Transplantation Medicine, Mayo Clinic, Scottsdale, Arizona 85054, USA. Rodriguez-Luna.Hector@Mayo.Edu
Hector
H
Rodriguez-Luna
Hugo E
HE
Vargas
Pratima
P
Sharma
Jose
J
Ortiz
Giovanni
G
De Petris
Vijayan
V
Balan
Thomas
T
Byrne
Adyr
A
Moss
David
D
Mulligan
Jorge
J
Rakela
David D
DD
Douglas
D000328:Adult; D000368:Aged; D001130:Arizona / Q000453:epidemiology; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005838:Genotype; D006084:Graft Rejection / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000821:virology; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000821:virology; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012008:Recurrence; D012189:Retrospective Studies
D004279:DNA, Viral