title: Liver transplantation for HCV cirrhosis; cautious optimism after 10 years of experience.
abstract: BACKGROUND
  Currently, HCV (hepatitis C virus) cirrhosis is one of the most common indications for liver transplantation (LTx) in Europe and North America among adults. Very early after LTx, histological examinations of liver biopsies in a group of HCV-positive recipients show important differences compared to other indications for transplantation.
  
  
  METHODS
  We described results of 121 primary LTx for HCV cirrhosis. HCV-RNA PCR was positive in 94% of primary graft recipients prior to LTx. Co-existing HCC was diagnosed in 20.66% of recipients.
  
  
  RESULTS
  One-year, 5-year, and 10-year survivals in the HCV-positive recipient group were 87.6%, 85.9%, and 84.3%, respectively. Symptomatic recurrent hepatitis was diagnosed in 58/121 (47.54%) recipients, and 41.3% presented with recurrence within the first 6 months. None of the PCR-negative recipients developed recurrent hepatitis prior to LTx. The rescue therapy for recurrent HCV hepatitis consist of Interferon and Ribavirin; the sustained virologic response (SVR) was obtained in 50% and 41% of recipients at 24 and 48 weeks, respectively, after treatment cessation.
  
  
  CONCLUSIONS
  Despite almost universal recurrence of HCV after LTx, results of transplantation are relatively good. Modification of immunosuppression, younger organ selection, and avoiding steroid pulses for rejection improve the results. Inclusion of combination therapy with interferon and Ribavirin allows for more than 40% SVR.
authors.affiliation: Department of General Surgery and Transplantology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Pacholczyk
authors.forename: Beata
authors.initials: B
authors.lastname: Łągiewska
authors.forename: Wojciech
authors.initials: W
authors.lastname: Lisik
authors.forename: Olga
authors.initials: O
authors.lastname: Tronina
authors.forename: Dariusz
authors.initials: D
authors.lastname: Wasiak
authors.forename: Tomasz
authors.initials: T
authors.lastname: Cieciura
authors.forename: Andrzej
authors.initials: A
authors.lastname: Chmura
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000401:mortality / Q000601:surgery* / Q000821:virology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D012254:Ribavirin / Q000627:therapeutic use; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D012254:Ribavirin; D007372:Interferons