Recurrence of clinically significant hepatitis A following liver transplantation for fulminant hepatitis A.
BACKGROUND
We report hepatitis A virus (HAV) infection of a liver allograft following transplantation for fulminant liver failure due to HAV infection. This rare condition has been described in only three patients to date. After liver transplantation allograft function was good, but starting 80 days after transplantation, episodes of acute graft dysfunction were observed.


OBJECTIVE
To elucidate the reason for acute hepatic dysfunction a large number of differential diagnoses were tested.


RESULTS
HAV RNA was undetectable for more than 80 days after transplantation. Detection of genomic HAV RNA by RT-PCR in serum and stool at the time of graft dysfunction led to the diagnosis of recurrent HAV infection.


CONCLUSIONS
We suggest that the risk of HAV reinfection after liver transplantation may be far higher than expected as results may be misinterpreted as rejection episodes.
Eisenbach
Christoph
C
Department of Gastroenterology and Hepatology, University of Heidelberg, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany. Christoph_Eisenbach@med.uni-heidelberg.de
Longerich
Thomas
T
Fickenscher
Helmut
H
Schalasta
Gunnar
G
Stremmel
Wolfgang
W
Encke
Jens
J
D006506:Hepatitis A / Q000821:virology*; D030041:Hepatitis A virus / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D017114:Liver Failure, Acute / Q000628:therapy*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis; D012008:Recurrence
D012367:RNA, Viral