title: Recurrence of clinically significant hepatitis A following liver transplantation for fulminant hepatitis A.
abstract: 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.
authors.affiliation: Department of Gastroenterology and Hepatology, University of Heidelberg, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany. Christoph_Eisenbach@med.uni-heidelberg.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Eisenbach
authors.forename: Thomas
authors.initials: T
authors.lastname: Longerich
authors.forename: Helmut
authors.initials: H
authors.lastname: Fickenscher
authors.forename: Gunnar
authors.initials: G
authors.lastname: Schalasta
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Stremmel
authors.forename: Jens
authors.initials: J
authors.lastname: Encke
mesh_terms: 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
chemical_list: D012367:RNA, Viral