Histological recurrent hepatitis C after liver transplantation: Outcome and role of retransplantation.
Impact of hepatitis C virus (HCV) recurrence on long-term outcome after orthotopic liver transplantation (OLT) is highly variable, and the role of retransplantation is still debated. From 1996 to 2003, 131 OLT with histologically proven HCV recurrence and 6 months of follow-up were retrospectively reviewed. One and 5-yr overall survivals were 90.7 and 81.3%, respectively. The mean time of HCV recurrence was 10.1 +/- 6.2 months in patients whose donor's age was less than 70 yr old, and 6.6 +/- 4.7 in patients whose donor's age was more than 70 (P < 0.01). The mean time between OLT and HCV recurrence was 10.7 +/- 8.2 months among patients still alive, and 5 +/- 4.2 among the 20 who died (P = 0.02). In 16 (12.2%) patients, retransplantation was required for severe HCV recurrence; 5 are still alive and 11 (68.7%) died. The mean survival time was 16.2 +/- 6 months if re-OLT was performed within 12 months from first OLT, and it was 45.9 +/- 10 months if re-OLT was performed later (P < 0.01). In conclusion, donors older than 70 yr are at high risk of early HCV recurrence; expectancy of life is significantly reduced in case of histologically proven recurrence within 6 months. Outcome is quite dismal in patients with early HCV recurrence requiring retransplantation within 1 yr of first OLT.
Ercolani
Giorgio
G
Department of Surgery and Transplantation, Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy. gercolani@aosp.bo.it
Grazi
Gian Luca
GL
Ravaioli
Matteo
M
Del Gaudio
Massimo
M
Cescon
Matteo
M
Varotti
Giovanni
G
Ramacciato
Giovanni
G
Vetrone
Gaetano
G
Zanello
Matteo
M
Pinna
Antonio Daniele
AD
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000473:pathology; D016174:Hepacivirus / Q000502:physiology; D006526:Hepatitis C / Q000473:pathology* / Q000601:surgery* / Q000821:virology; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012367:RNA, Viral / Q000235:genetics; D012008:Recurrence; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
D012367:RNA, Viral