PURPOSE: The aim of this study was to report the influence of hepatitis C virus (HCV) genotype and rejection episodes on the outcome of orthotopic liver transplantation (OLT), hepatitis recurrence, and progression to graft cirrhosis after OLT. METHODS: Fifty-three patients who all had undergone OLT for end-stage liver cirrhosis were selected for this study. Hepatitis C genotype was determined. Recurrent hepatitis and rejection were diagnosed based on elevated liver function tests and a liver biopsy. RESULTS: The patients were followed up for a mean of 51.9 +/- 34.3 months. The cumulative survival rate was no different in OLT for hepatitis C and OLT for all other liver diseases. After OLT, serum HCV RNA was detected in 93%. Histological recurrence occurred in 85% of all patients. The 1-, 3-, and 5-year recurrence rates were 48%, 77%, and 85%, respectively. Of the 41 patients with recurrent hepatitis C, 4 (10%) had cirrhosis, 18 (44%) had hepatitis with fibrosis, and 91 (46%) had hepatitis without fibrosis at the end of follow-up. A total of 32% of the patients were infected by HCV genotype 1b and 68% by other HCV genotypes. The recurrence rates were significantly higher in patients infected with genotype 1b than in those with other genotypes ( p = 0.04). Twenty of 48 patients (42%) experienced acute rejection. There was a strong association between the number of rejection episodes and the incidence of HCV-related cirrhosis ( p < 0.01). CONCLUSION: Our findings showed the genotype 1b to result in a higher recurrence rate after OLT. On the other hand, rejection episodes were associated with a more rapid progression to graft cirrhosis.
PURPOSE: The aim of this study was to report the influence of hepatitis C virus (HCV) genotype and rejection episodes on the outcome of orthotopic liver transplantation (OLT), hepatitis recurrence, and progression to graft cirrhosis after OLT. METHODS: Fifty-three patients who all had undergone OLT for end-stage liver cirrhosis were selected for this study. Hepatitis C genotype was determined. Recurrent hepatitis and rejection were diagnosed based on elevated liver function tests and a liver biopsy. RESULTS: The patients were followed up for a mean of 51.9 +/- 34.3 months. The cumulative survival rate was no different in OLT for hepatitis C and OLT for all other liver diseases. After OLT, serum HCV RNA was detected in 93%. Histological recurrence occurred in 85% of all patients. The 1-, 3-, and 5-year recurrence rates were 48%, 77%, and 85%, respectively. Of the 41 patients with recurrent hepatitis C, 4 (10%) had cirrhosis, 18 (44%) had hepatitis with fibrosis, and 91 (46%) had hepatitis without fibrosis at the end of follow-up. A total of 32% of the patients were infected by HCV genotype 1b and 68% by other HCV genotypes. The recurrence rates were significantly higher in patients infected with genotype 1b than in those with other genotypes ( p = 0.04). Twenty of 48 patients (42%) experienced acute rejection. There was a strong association between the number of rejection episodes and the incidence of HCV-related cirrhosis ( p < 0.01). CONCLUSION: Our findings showed the genotype 1b to result in a higher recurrence rate after OLT. On the other hand, rejection episodes were associated with a more rapid progression to graft cirrhosis.
Authors: Jennifer E Layden; Scott Cotler; Kimberly A Brown; Michael R Lucey; Helen S Te; Sheila Eswaran; Claus Fimmel; Thomas J Layden; Nina M Clark Journal: Transplantation Date: 2012-07-27 Impact factor: 4.939
Authors: Hui Li; Daniel G Sullivan; Nathan Feuerborn; Susan McArdle; Kirubeal Bekele; Sampa Pal; Matthew Yeh; Robert L Carithers; James D Perkins; David R Gretch Journal: Virology Date: 2010-04-18 Impact factor: 3.616
Authors: Hatim Mudawi; Ahmed Helmy; Yasser Kamel; Mohammed Al Saghier; Mohammed Al Sofayan; Mohammed Al Sebayel; Hatem Khalaf; Hamad Al Bahili; Yasser Al Shiek; Khalil Alawi; Ahmed Aljedai; Hazem Mohamed; Waleed Al Hamoudi; Ayman Abdo Journal: Ann Saudi Med Date: 2009 Mar-Apr Impact factor: 1.526
Authors: Kurinchi Selvan Gurusamy; Emmanuel Tsochatzis; Clare D Toon; Brian R Davidson; Andrew K Burroughs Journal: Cochrane Database Syst Rev Date: 2013-12-02
Authors: Kurinchi Selvan Gurusamy; Emmanuel Tsochatzis; Clare D Toon; Elias Xirouchakis; Andrew K Burroughs; Brian R Davidson Journal: Cochrane Database Syst Rev Date: 2013-12-04