Digestive Diseases and Sciences

, Volume 58, Issue 5, pp 1403–1409 | Cite as

Hepatic Preservation Injury: Severity of Hepatitis C Recurrence and Survival After Liver Transplantation

  • Anthony J. Michaels
  • Renumathy Dhanasekaran
  • David P. Foley
  • Ahmad Alkhasawneh
  • Lisa Dixon
  • Consuelo Soldevila-Pico
  • Giuseppe Morelli
  • Roniel Cabrera
  • Virginia C. Clark
  • Roberto J. Firpi
Original Article



Preservation injury in the HCV liver transplant population has been reported to correlate with poorer survival outcomes compared to preservation injury in the non-HCV liver transplant population. However, determinants of progression to cirrhosis in HCV infection remain poorly defined in this population.


This study aimed to determine if the presence and severity of preservation injury impact the acceleration of HCV recurrence and survival after liver transplant.


We retrospectively reviewed liver transplant HCV patients over a 10-year period. Biopsies from postoperative day 7 were assessed for preservation injury and 4- and 12-month biopsies were assessed for fibrosis. Patients with Ishak fibrosis >0.8 Units/year were considered rapid fibrosers.


Our study group consisted of 255 patients. The mean age was 49.3 years old, 180 (70.6 %) were male, and 221 (86.7 %) were Caucasian. The incidence of preservation injury on the 7-day biopsy was 69.0 %. A strong correlation between postoperative peak AST within the first week and preservation injury was found. The overall prevalence of rapid fibrosers at 4 months, 1 and 2 years was 47.4, 75.2, and 58.9 %, respectively. The prevalence of rapid fibrosers at 4 months, 1 and 2 years between patients with or without preservation injury was not statistically significant (p = 0.39, p = 0.46, and p = 0.53, respectively). No differences were seen between patients with and without PI in terms of patient and graft survival.


In this study, the presence and severity of preservation injury were not associated with development of rapid HCV recurrence or worsening in survival.


Hepatic ischemia Reperfusion injury Liver transplant Hepatitis C Fibrosis 


Conflict of interest



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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Anthony J. Michaels
    • 3
  • Renumathy Dhanasekaran
    • 1
  • David P. Foley
    • 4
  • Ahmad Alkhasawneh
    • 2
  • Lisa Dixon
    • 2
  • Consuelo Soldevila-Pico
    • 1
  • Giuseppe Morelli
    • 1
  • Roniel Cabrera
    • 1
  • Virginia C. Clark
    • 1
  • Roberto J. Firpi
    • 1
  1. 1.Division of Gastroenterology, Hepatology and Nutrition Section of Hepatobiliary Diseases and Liver Transplantation, Department of MedicineUniversity of FloridaGainesvilleUSA
  2. 2.Department of PathologyUniversity of FloridaGainesvilleUSA
  3. 3.Division of Gastroenterology and HepatologyThe Ohio State University Medical CenterColumbusUSA
  4. 4.Department of SurgeryUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA

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