Optimizing outcome of recurrent hepatitis C virus genotype 4 after living donor liver transplantation: moving forward by looking back.
OBJECTIVE
Recurrence of HCV after LDLT is almost universal. Different factors affect response to treatment. Few data are available regarding outcome of recurrent HCV genotype 4. The purpose of this study is to improve outcome of recurrent HCV genotype 4 after LDLT.


METHODS
An IRB approved chart review of 243 patients transplanted for ESLD, HCV genotype 4 over 4 years were reviewed. Protocol liver biopsies were taken 6 months after transplant. Patients received pegylated interferon and ribavirin in case of histological recurrence. Five patients had FCH were excluded.


RESULTS
Thirty-seven patients were included. Sustained Virological Response (SVR) was achieved in 29 (78.3%). Patients with Metavir fibrosis stage (F0) and (F1) had SVR in 5/5 (100%) and 20/24 (83.3%). Two patients with F1 had to stop treatment because of thrombocytopenia and 2 were non responders. Three out of 6 patients (50%) with (F2) had SVR, 2 were non responders and one had to discontinue treatment because of severe depression. One of 2 patients (50%) with F3 had SVR and the other patient decompensated within 4 months before treatment and died.


CONCLUSIONS
Protocol biopsies allow early detection of inflammatory changes in the graft before fibrosis occurs. Early treatment of recurrent HCV genotype 4 after LDLT results in better response.
Ain Shams Center for Organ Transplant, Cairo, Egypt. Electronic address: drhdabbous@yahoo.com.
H M
HM
Dabbous
Ain Shams Center for Organ Transplant, Cairo, Egypt.
M S
MS
Elmeteini
Ain Shams Center for Organ Transplant, Cairo, Egypt.
M A
MA
Sakr
Ain Shams Center for Organ Transplant, Cairo, Egypt.
I F
IF
Montasser
Ain Shams Center for Organ Transplant, Cairo, Egypt.
M
M
Bahaa
Ain Shams Center for Organ Transplant, Cairo, Egypt.
A
A
Abdelaal
Ain Shams Center for Organ Transplant, Cairo, Egypt.
M
M
Fathy
Ain Shams Center for Organ Transplant, Cairo, Egypt.
R
R
Refaie
Ain Shams Center for Organ Transplant, Cairo, Egypt.
M
M
Seyam
Ain Shams Center for Organ Transplant, Cairo, Egypt.
A
A
Abdelmonem
Ain Shams Center for Organ Transplant, Cairo, Egypt.
A
A
Mukhtar
Ain Shams Center for Organ Transplant, Cairo, Egypt.
N
N
Hegazy
Ain Shams Center for Organ Transplant, Cairo, Egypt.
M
M
Almoneiri
D000328:Adult; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D006526:Hepatitis C / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome