Outcomes after lung transplantation in patients with chronic hepatitis C virus infection.
BACKGROUND
Hepatitis C virus (HCV) infects 4 million people in the USA, with a prevalence of 1.4%. The seropositivity rate among potential lung transplant candidates is 1.9%, yet little information is available regarding outcomes of lung transplantation in HCV-positive lung transplant recipients. Our study reports outcomes of lung transplantation in HCV-positive recipients and compares them to HCV-negative controls.


METHODS
A retrospective analysis of the Cleveland Clinic Foundation's lung transplant database (465 patients) identified six HCV-positive patients. Demographic data, etiology of HCV infection, HCV viral load pre- and post-transplant, pre-transplant hepatic pathology, serial transaminases, incidence of acute hepatitis, graft function data and patient survival data were obtained by chart extraction.


RESULTS
Five HCV-positive recipients had a pre-transplant liver biopsy, none of whom had evidence of cirrhosis pre-transplant. Although HCV RNA levels markedly increased post-transplant, no concomitant increase in transaminases was noted. There was no significant difference in the incidence of acute rejection at 1 year in our HCV-positive cohort compared with the HCV-negative lung transplant recipients from our institution. One patient developed bronchiolitis obliterans syndrome (BOS) during the follow-up period. Two patient deaths occurred, one at 8 months and the other at 2 years post-transplant. No evidence of hepatic dysfunction was noted in either deceased patient. The four surviving patients are alive at a median 3.2 years (range 1 to 6 years).


CONCLUSIONS
No significant difference in patient or graft survival was noted between the HCV-positive lung transplant recipients and the HCV-negative recipients.
Sahi
Hina
H
Department of Pulmonary, Allergy and Critical Care Medicine, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Zein
Nizar N
NN
Mehta
Atul C
AC
Blazey
Holli C
HC
Meyer
Kathryn H
KH
Budev
Marie
M
D000328:Adult; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D019698:Hepatitis C, Chronic / Q000175:diagnosis* / Q000401:mortality*; D006801:Humans; D008111:Liver Function Tests; D016040:Lung Transplantation / Q000009:adverse effects / Q000379:methods / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D013997:Time Factors