Digestive Diseases and Sciences

, Volume 58, Issue 10, pp 3010–3016

Intravenous Interferon Administered During Liver Transplantation Is Not Effective in Preventing Hepatitis C Reinfection

  • Mark W. Russo
  • Tarun Narang
  • Lon Eskind
  • Daniel Hayes
  • Vincent Casingal
  • Preston P. Purdum
  • John S. Hanson
  • Will Ahrens
  • James Norton
  • Herbert Bonkovsky
Original Article

DOI: 10.1007/s10620-013-2749-z

Cite this article as:
Russo, M.W., Narang, T., Eskind, L. et al. Dig Dis Sci (2013) 58: 3010. doi:10.1007/s10620-013-2749-z

Abstract

Background

Post-transplant hepatitis C is a major challenge after liver transplantation (LT). Antiviral therapy is associated with lower efficacy in the post-transplant setting.

Aims

The purpose of this study was to determine the safety and effect of intravenous interferon (IFN) during the anhepatic phase of LT on hepatitis C viral load.

Methods

Fifteen consecutive subjects undergoing liver transplant for hepatitis C cirrhosis were enrolled in the study, ten of which received study drug and five subjects served as controls. Cases received weight-based ribavirin and subcutaneous IFN at time of incision followed by intravenous IFN at the start of the anhepatic phase. Adverse events and viral levels were recorded. Repeated measures ANOVA was employed to test for differences over time, between the groups, and time by group interaction.

Results

All subjects had genotype 1 virus. Hepatitis C viral load was lower at week 4 in cases compared to controls (769,004 ± 924,082 IU/ml and 2,329,896 ± 3,731,749 IU/ml, respectively), but did not reach statistical significance (p = 0.50). Three subjects developed adverse events related to IFN including pulmonary edema, rejection, and neutropenia.

Conclusions

Intravenous IFN administered during the anhepatic phase of liver transplant did not prevent graft reinfection and was associated with manageable adverse events. This regimen could be further studied if direct acting antiviral agents alone are insufficient for treating post-transplant hepatitis C.

Keywords

Transplantation Hepatitis C Antiviral Infection Ribavirin 

Abbreviations

TAC

Tacrolimus

ANC

Absolute neutrophil count

IFN

Interferon

FCH

Fibrosing cholestatic hepatitis C

RBV

Ribavirin

SVR

Sustained virologic response

LT

Liver transplantation

NS

Not significant

MELD

Model for end stage liver disease

IL

Interleukin

HCV

Hepatitis C virus

ALT

Alanine aminotransferase

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Mark W. Russo
    • 1
  • Tarun Narang
    • 1
  • Lon Eskind
    • 2
  • Daniel Hayes
    • 2
  • Vincent Casingal
    • 2
  • Preston P. Purdum
    • 1
  • John S. Hanson
    • 1
  • Will Ahrens
    • 3
  • James Norton
    • 4
  • Herbert Bonkovsky
    • 1
    • 4
  1. 1.Transplant Center, Department of MedicineCarolinas Medical CenterCharlotteUSA
  2. 2.Department of SurgeryCarolinas Medical CenterCharlotteUSA
  3. 3.Department of PathologyCarolinas Medical CenterCharlotteUSA
  4. 4.Cannon ResearchCarolinas Medical CenterCharlotteUSA