Living donor liver transplantation for hepatitis C-related cirrhosis: no difference in histological recurrence when compared to deceased donor liver transplantation recipients.
The question of possible earlier and more aggressive recurrence of hepatitis C virus (HCV) infection after living donor liver transplantation (LDLT) compared to deceased donor liver transplantation (DDLT) remains unanswered. To address this issue we retrospectively reviewed virological, histological, and clinical data in 67 patients (52 DDLT and 15 LDLT) who underwent liver transplant for their HCV-related cirrhosis since April 2001. Our data indicate that there is no statistical difference between LDLT and DDLT groups in mean age, Child-Turcotte-Pugh score, model for end-stage liver disease score, and gender distribution. The mean follow-up was 749 +/- 371 days in LDLT and 692 +/- 347 days in DDLT. The predominant genotype in the LDLT and DDLT are genotype 1 (LDLT, 91%; DDLT, 70%). All patients with histologically confirmed recurrent HCV had detectable HCV-RNA in serum. The histological recurrence rate of hepatitis C was 58% at 4 months, 90% at 1 year, and 100% at 2 years in LDLT patients vs. 71% at 4 months, 94% at 1 year, and 95% at 2 years in DDLT patients (not significant) Comparison of the activity of inflammation and fibrosis score at all time points failed to show a statistical difference. Kaplan-Meier survival analysis showed similar patient and graft survival rates between the 2 groups. Our data indicate that histological recurrence of HCV is an early event and virtually universal 2 years' posttransplantation, regardless of modality of donor procurement.
Division of Transplantation Medicine, Mayo Clinic Hospital, Phoenix, AZ 85054, USA.
Linsheng
L
Guo
Mauricio
M
Orrego
Hector
H
Rodriguez-Luna
Vijiyan
V
Balan
Thomas
T
Byrne
Kapil
K
Chopra
David D
DD
Douglas
Edwyn
E
Harrison
Adyr
A
Moss
K Sudhakar
KS
Reddy
James W
JW
Williams
Jorge
J
Rakela
David
D
Mulligan
Hugo E
HE
Vargas
D000328:Adult; D002102:Cadaver; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000150:complications* / Q000473:pathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D016031:Liver Transplantation / Q000401:mortality / Q000473:pathology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D014019:Tissue Donors; D016896:Treatment Outcome