Effect of ischemia-reperfusion on the incidence of acute cellular rejection and timing of histologic hepatitis C virus recurrence after liver transplantation.
BACKGROUND
Because of a critical shortage of deceased donor (DD) livers, more extended criteria allografts are being utilized; these allografts are at increased risk for ischemia-reperfusion injury (IRI). We assessed whether, in a large cohort of patients transplanted for hepatitis C virus (HCV) either via a DD or live donor (LD), there was a relationship between the degree of IRI and the frequency and timing of acute cellular rejection (ACR) and histologic HCV recurrence.


METHODS
During an 8-year study, patients were separated into four groups based on peak alanine aminotransferase (ALT) levels and three groups based on severity of IRI on postreperfusion liver biopsy.


RESULTS
The mean follow-up time of 433 DD and 44 LD recipients was 1212 days. We noted a strong correlation in DD between peak ALT and the histologic degree of IRI (P = .01). There was no difference in the incidence or grade of ACR among the four groups. There was no correlation between the severity of IRI and the incidence or time to histologic recurrence of HCV.


CONCLUSIONS
The magnitude of peak ALT correlated with the severity of IRI on postreperfusion liver biopsy. Among this large HCV cohort, there was no correlation between the severity of IRI and the incidence or timing of histologic HCV recurrence or incidence of ACR.
Killackey
M T
MT
Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, USA.
Gondolesi
G E
GE
Liu
L U
LU
Paramesh
A S
AS
Thung
S N
SN
Suriawinata
A
A
Nguyen
E
E
Roayaie
S
S
Schwartz
M E
ME
Emre
S
S
Schiano
T D
TD
D000208:Acute Disease; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D006084:Graft Rejection / Q000453:epidemiology*; D006526:Hepatitis C / Q000601:surgery*; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation; D019520:Living Donors; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology*; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D015427:Reperfusion Injury / Q000150:complications*; D012189:Retrospective Studies; D014019:Tissue Donors; D014184:Transplantation, Homologous
D000410:Alanine Transaminase