Hepatitis C recurrence after liver transplant generally mild, study finds.
At Digestive Disease Week 2003, held in Orlando, FL in May, Lukas Hinterhuber, MD described 118 patients who underwent liver transplantation for HCV between 1986 and 2003 at the University of Innsbruck. Of these, 84 patients were male, 34 were female, mean patient age was 56 years, and mean donor age was 35 years.
Posttransplant HCV recurrence tended to be mild portal, lobular, or mixed. Cholestatic hepatitis developed in 12 patients, 9 of whom died. The incidence of cirrhosis with HCV recurrence was very low-approximately 5%.
"Except for the cholestatic type, HCV recurrence did not adversely influence patient or graft survival," reported Hinterhuber. Survival rates ranged from 83% at 1year to 59% at 10 years.
Meeting attendee Charles Kuckel, MD, commented that his experience at the University of Medicine and Dentistry of New Jersey in Newark has been much different. "We've had a lot of problems with post-liver transplant HCV recurrence," he said, theorizing that this might be due to the genotype of the virus and/or the older age of the donors (over 37 years).
Kuckel also pointed to the higher percentage of living donors used by the Austrian team-around 25% to 30%. "We use cadaveric donors almost exclusively. That makes a very big difference. You don't know the history [of the donor]. With a living donor, you can test for everything."