title: Fibrosis progression after liver transplantation in patients with recurrent hepatitis C.
abstract: OBJECTIVE
  Aim of our study was to analyze fibrosis progression after liver transplantation (OLT) in hepatitis C virus (HCV)-infected patients based on protocol liver biopsies and to identify risk factors, which may play a role in the development of severe fibrosis stages.
  
  
  METHODS
  One hundred and eighty-three liver graft recipients who had a histological follow-up evaluation of 1 year after OLT were analyzed. Overall 1039 protocol liver biopsies were performed after 1-, 3-, 5-, 7- and 10 years and staged according to the Scheuer score.
  
  
  RESULTS
  The fibrosis progression rate was not linear. The fibrosis scores were 1.2 after one, 1.7 after three, 1.9 after five, 2.1 after 7 and 2.2 after 10 years. The 39 recipients with fibrosis stages 3 or 4 in the 1-year biopsy had a significantly reduced survival rate, while fibrosis stage 0-2 indicated excellent survival. Independent risk factors for progression of fibrosis at 1 year were HCV genotype 1 and 4 (P=0.01) and donor age>33 years (P=0.01), whereas risk factors for development of cirrhosis (30/183 recipients (16%)) were donor age (P=0.002) and multiple steroid pulses (P=0.05).
  
  
  CONCLUSIONS
  These data provide information on the course of recurrent hepatitis C and may be helpful to individualize the treatment of transplanted patients.
authors.affiliation: Klinik für Allgemein-, Viszeral-, und Transplantationschirurgie, Universitätsklinikum Charité, Campus Virchow-Klinikum, Humboldt-Universität zu Berlin, D-13353 Berlin, Germany. ulf.neumann@charite.de
authors.forename: Ulf P
authors.initials: UP
authors.lastname: Neumann
authors.forename: Thomas
authors.initials: T
authors.lastname: Berg
authors.forename: Marcus
authors.initials: M
authors.lastname: Bahra
authors.forename: Daniel
authors.initials: D
authors.lastname: Seehofer
authors.forename: Jan M
authors.initials: JM
authors.lastname: Langrehr
authors.forename: Ruth
authors.initials: R
authors.lastname: Neuhaus
authors.forename: Cornelia
authors.initials: C
authors.lastname: Radke
authors.forename: Peter
authors.initials: P
authors.lastname: Neuhaus
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D019698:Hepatitis C, Chronic / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality* / Q000473:pathology / Q000821:virology*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000473:pathology / Q000821:virology; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate