Fibrosis progression after liver transplantation in patients with recurrent hepatitis C.
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.
Neumann
Ulf P
UP
Klinik für Allgemein-, Viszeral-, und Transplantationschirurgie, Universitätsklinikum Charité, Campus Virchow-Klinikum, Humboldt-Universität zu Berlin, D-13353 Berlin, Germany. ulf.neumann@charite.de
Berg
Thomas
T
Bahra
Marcus
M
Seehofer
Daniel
D
Langrehr
Jan M
JM
Neuhaus
Ruth
R
Radke
Cornelia
C
Neuhaus
Peter
P
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