title: Risk factors in patients with rapid recurrent hepatitis C virus-related cirrhosis within 1 year after liver transplantation.
abstract: BACKGROUND
  Recurrent cirrhosis (RC) due to pretransplant underlying disease leads to organ failure and subsequent death after orthotopic liver transplantation (OLT). RC occurs in up to 30% of patients with recurrent hepatitis C (HCV) within 5 years after OLT. We sought to identify early risk factors for rapid RC within the first year after OLT in HCV-positive patients.
  
  
  METHODS
  Among 404 liver transplanted patients at the University of Mainz between 1998 and 2008, 90 were HCV-RNA positive. To identify predictive factors for rapid RC, we compared HCV-positive patients with advanced fibrosis stages within 1 year after OLT (n = 13) with these without RC at 5 years after OLT (n = 23).
  
  
  RESULTS
  Overall, poorer patient survival was associated with advanced fibrosis scores in the 1-year protocol biopsy and nonresponse to interferon treatment before OLT. The strongest predictive factors for rapid RC were persistently high levels of alkaline phosphatase, bilirubin, viral load at 6 months after OLT, and multiple steroid pulse therapies. The CCR2-V64I polymorphism was not associated with rapid RC.
  
  
  CONCLUSIONS
  We presented a group of patients with HCV-related rapid RC within the first year after OLT to identify predictive factors for rapid fibrosis progression.
authors.affiliation: First Department of Medicine, University of Mainz, Mainz, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Zimmermann
authors.forename: C
authors.initials: C
authors.lastname: Otto
authors.forename: M
authors.initials: M
authors.lastname: Hoppe-Lotichius
authors.forename: S
authors.initials: S
authors.lastname: Biesterfeld
authors.forename: A
authors.initials: A
authors.lastname: Lautem
authors.forename: M
authors.initials: M
authors.lastname: Knaak
authors.forename: A
authors.initials: A
authors.lastname: Zimmermann
authors.forename: A P
authors.initials: AP
authors.lastname: Barreiros
authors.forename: M
authors.initials: M
authors.lastname: Heise
authors.forename: J M
authors.initials: JM
authors.lastname: Schattenberg
authors.forename: M F
authors.initials: MF
authors.lastname: Sprinzl
authors.forename: P R
authors.initials: PR
authors.lastname: Galle
authors.forename: G
authors.initials: G
authors.lastname: Otto
authors.forename: M
authors.initials: M
authors.lastname: Schuchmann
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000821:virology*; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D017741:Survivors; D013997:Time Factors; D019562:Viral Load