Predictors of disease recurrence post living donor liver transplantation in end stage chronic HCV patients.
HCV recurrence represents a universal phenomenon after liver transplantation. In this study Fifty HCV patients who underwent living donor liver transplantation were enrolled and factors that may accelerate HCV reinfection of the allograft such as donor's age and degree of liver steatosis, recipient's age, gender, BMI, MELD score, liver functions, HCV viral load, type of immunosuppressive drug, and genetic polymorphisms of IL28B, OAS, and IL1B were studied. The results of disease-free survival (DFS) rates showed inverse correlation with the recipient's postoperative levels of ALT, AST, ALP (P < 0.001, <0.001, and 0.006 resp.) as well as pre- and postoperative titers of HCV RNA (P < 0.003 and <0.001 resp.). Recipient's IL28B SNP was a significant factor in predicting postoperative DFS (P < 0.025). However, SNPs in OAS and IL1B genes had no apparent correlation with DFS. Cox proportional hazards model revealed that patients with elevated levels of ALT, preoperative viral titers, IL28B CT, and IL28B TT were 8.28, 4.22, 3.35, and 1.36 times, respectively, more likely to develop recurrence. In conclusion IL28B SNP, ALT level, and preoperative HCV titer besides proper choice of immunosuppressant are helpful for predicting posttransplant HCV recurrence and DFS.
Department of Microbial Biotechnology, National Research Center, Dokki, Cairo, 12622, Egypt.
Mostafa K
MK
El Awady
Department of Microbial Biotechnology, National Research Center, Dokki, Cairo, 12622, Egypt.
Noha G
NG
Bader El Din
El Sahel Teaching Hospital, Ministry of Health, Al Kornich Shoubra, Cairo, Egypt.
Mahmoud
M
Abdel Aziz Riad
Department of Microbial Biotechnology, National Research Center, Dokki, Cairo, 12622, Egypt.
Moataza H
MH
Omran
Department of Microbial Biotechnology, National Research Center, Dokki, Cairo, 12622, Egypt.
Tawfeek H
TH
Abdelhafez
Department of Tropical Medicine, Kasr El Aini, Cairo University, Cairo, Egypt.
Tamer Mahmoud
TM
Elbaz
Department of Tropical Medicine, Kasr El Aini, Cairo University, Cairo, Egypt.
Shereen Shoukry
SS
Hunter
Department of Microbial Biotechnology, National Research Center, Dokki, Cairo, 12622, Egypt.
Reham M
RM
Dawood
Department of Tropical Medicine, Kasr El Aini, Cairo University, Cairo, Egypt.
Ashraf O
AO
Abdel Aziz
D015088:2',5'-Oligoadenylate Synthetase / Q000235:genetics; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D060085:Coinfection / Q000097:blood / Q000473:pathology; D003586:Cytomegalovirus Infections / Q000097:blood / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D056726:Genetic Association Studies; D006084:Graft Rejection / Q000517:prevention & control; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000235:genetics / Q000401:mortality / Q000601:surgery; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007372:Interferons; D053583:Interleukin-1beta / Q000235:genetics; D007378:Interleukins / Q000235:genetics; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D016016:Proportional Hazards Models; D012367:RNA, Viral / Q000097:blood; D012008:Recurrence; D019562:Viral Load; D055815:Young Adult; D000095022:Interferon Lambda
D015088:2',5'-Oligoadenylate Synthetase; D015415:Biomarkers; D007166:Immunosuppressive Agents; D007372:Interferons; D053583:Interleukin-1beta; D007378:Interleukins; D012367:RNA, Viral; C000624353:interferon-lambda, human; D000095022:Interferon Lambda; C508585:IL1B protein, human; C475085:OAS1 protein, human