Liver transplantation for hepatitis C virus‐related cirrhosis

Nancy L. Ascher, John R. Lake, Jean Emond, John Roberts

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141 Scopus citations

Abstract

Since the introduction of techniques to reliably identify antibody to the hepatitis C virus and quantitation of hepatitis C virus, there has been an increasing interest in the behavior of chronic hepatitis C infection with liver transplantation. Ninety‐seven patients with chronic active hepatitis C and fifty‐nine patients with cryptogenic cirrhosis underwent 100 and 62 liver transplantation procedures, respectively, at a single institution. This represents 35% of the total liver transplantations performed during this time period. Twenty‐three percent of transplants were performed in patients with evidence of chronic active hepatitis C. Patients and graft survival were excellent in both groups. One‐, 2‐ and 3‐yr patient survival rates for chronic active hepatitis C and cryptogenic cirrhosis were 94%, 89% and 87% and 84%, 84% and 73%, respectively. Hepatitis C can frequently be identified after transplantation. More than 95% of patients show persistence of antibody to the hepatitis C virus. Forty‐one of 95 patients (surviving>1 mo) showed recurrent hepatitis (initially seen 3 to 20 mo after transplantation), and 12 progressed to chronic active hepatitis. In 16 patients of the cryptogenic group in whom hepatitis developed, 11 were associated with de novo hepatitis C infection. Seven of these 11 cases went on to a chronic state. Of 11 deaths after transplant in the hepatitis C group, 2 were directly related to recurrent disease. There were 15 deaths in the cryptogenic group, 2 related to de novo hepatitis C. Patients were not serotyped. Interferon therapy was attempted in a small number of patients with disease, with inconclusive results. These data indicate that patients with chronic active hepatitis C have excellent shortterm results after liver transplantation. With longer follow‐up, we may see an increasing number of patients with recurrent hepatitis or poor outcome with specific viral serotypes. (Hepatology 1994;20:24S–27S.)

Original languageEnglish (US)
Pages (from-to)S24-S27
JournalHepatology
Volume20
Issue number7 S
DOIs
StatePublished - Jul 1994

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