Skip to main content
Log in

Hepatitis C in liver transplant patients

  • Published:
Current Hepatitis Reports Aims and scope Submit manuscript

Abstract

Hepatitis C virus (HCV) presents multiple challenges related to liver transplantation; it is the most common indication for liver transplantation in the United States but is universally recurrent in patients who are viremic at the time of transplantation. When HCV recurs in the transplanted liver, histologic injury may be severe, and progression toward advanced fibrosis with decompensation is more rapid when compared with the natural history of HCV before transplantation. This review summarizes new information related to the treatment, recognition, and management of HCV in patients who undergo liver transplantation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Gane EJ, Portmann BC, Naoumov NV, et al.: Long-term outcome of hepatitis C infection after liver transplantation. N Engl J Med 1996, 334:815–820.

    Article  PubMed  CAS  Google Scholar 

  2. Berenguer M, Ferrell L, Watson J, et al.: HCV-related fibrosis progression following liver transplantation: increase in recent years. J Hepatol 2000, 32:673–684.

    Article  PubMed  CAS  Google Scholar 

  3. Berenguer M, Prieto M, Rayon JM, et al.: Natural history of clinically compensated HCV-related graft cirrhosis after liver transplantation. Hepatology 2000, 32:852–858.

    Article  PubMed  CAS  Google Scholar 

  4. Forman LM, Lewis JD, Berlin JA, et al.: The association between hepatitis C infection and survival after orthotopic liver transplantation. Gastroenterology 2002, 122:889–896.

    Article  PubMed  Google Scholar 

  5. Kemmer N, Kaiser TE, Zacharias V, et al.: Revisiting posttransplant survival for hepatitis C virus recipients. Transplantation 2007, 84:932–933.

    Article  PubMed  Google Scholar 

  6. Cammà C, Di Bona D, Schepis F, et al.: Effect of peginterferon alfa-2a on liver histology in chronic hepatitis C: a meta-analysis of individual patient data. Hepatology 2004, 39:333–340.

    Article  PubMed  CAS  Google Scholar 

  7. Poynard T, McHutchison J, Manns M, et al.: Impact of pegylated interferon alfa-2b and ribavirin on liver fibrosis in patients with chronic hepatitis C. Gastroenterology 2002, 122:1303–1313.

    Article  PubMed  CAS  Google Scholar 

  8. Veldt BJ, Heathcote EJ, Wedemeyer H, et al.: Sustained virologic response and clinical outcomes in patients with chronic hepatitis C and advanced fibrosis. Ann Intern Med. 2007, 147:677–684.

    PubMed  Google Scholar 

  9. Iacobellis A, Siciliano M, Perri F, et al.: Peginterferon alfa-2b and ribavirin in patients with hepatitis C virus and decompensated cirrhosis: a controlled study. J Hepatol 2007, 46:206–212.

    Article  PubMed  CAS  Google Scholar 

  10. Weksler BB: Review article: the pathophysiology of thrombocytopenia in hepatitis C virus infection and chronic liver disease. Aliment Pharmacol Ther 2007, 26:13–19.

    PubMed  CAS  Google Scholar 

  11. Di Bisceglie AM, Shiffman ML, Everson GT, et al.: Prolonged antiviral therapy with peginterferon to prevent complications of advanced liver disease associated with hepatitis C: results of the Hepatitis C Antiviral Long-term Treatment against Cirrhosis (HALT-C) Trial. Hepatology 2007, 46(Suppl 1):290A.

    Google Scholar 

  12. Everson GT, Trotter J, Forman L, et al.: Treatment of advanced hepatitis C with a low accelerating dosage regimen of antiviral therapy. Hepatology 2005, 42:255–262.

    Article  PubMed  CAS  Google Scholar 

  13. Sherman M: Optimizing management strategies in special patient populations. Am J Gastroenterol 2006, 101(Suppl 1):S26–S31.

    Article  PubMed  Google Scholar 

  14. Lee LP, Dai CY, Chuang WL, et al.: Comparison of liver histopathology between chronic hepatitis C patients and chronic hepatitis B and C-coinfected patients. J Gastroenterol Hepatol 2007, 22:515–517.

    Article  PubMed  Google Scholar 

  15. Cheruvu S, Marks K, Talal AH: Understanding the pathogenesis and management of hepatitis B/HIV and hepatitis B/hepatitis C virus coinfection. Clin Liver Dis 2007, 11:917–943.

    Article  PubMed  Google Scholar 

  16. Merchante N, Jiménez-Saenz M, Pineda JA: Management of HCV-related end-stage liver disease in HIV-coinfected patients. AIDS Rev 2007, 9:131–139.

    PubMed  Google Scholar 

  17. McGovern BH: Hepatitis C in the HIV-infected patient. J Acquir Immune Defic Syndr 2007, 45:S47–S45.

    Article  PubMed  Google Scholar 

  18. Bonacini M: Diagnosis and management of cirrhosis in coinfected patients. J Acquir Immune Defic Syndr 2007, 45:S38–S44.

    Article  PubMed  Google Scholar 

  19. Morra R, Munteanu M, Imbert-Bismut F, et al.: FibroMAX: towards a new universal biomarker of liver disease? Expert Rev Mol Diagn 2007, 7:481–489.

    Article  PubMed  Google Scholar 

  20. Halfon P, Bourliere M, Deydier R, et al.: Independent prospective multicenter validation of biochemical markers (fibrotest-actitest) for the prediction of liver fibrosis and activity in patients with chronic hepatitis C: the fibropaca study. Am J Gastroenterol 2006, 101:547–555.

    Article  PubMed  Google Scholar 

  21. Huwart L, Sempoux C, Salameh N, et al.: Liver fibrosis: noninvasive assessment with MR elastography versus aspartate aminotransferase-to-platelet ratio index. Radiology 2007, 245:458–460.

    Article  PubMed  Google Scholar 

  22. Talwalkar JA, Kurtz DM, Schoenleber SJ, et al.: Ultrasound-based transient elastography for the detection of hepatic fibrosis: systematic review and meta-analysis. Clin Gastroenterol Hepatol 2007, 5:1214–1220.

    Article  PubMed  Google Scholar 

  23. Roche B, Samuel D: Risk factors for hepatitis C recurrence after liver transplantation. J Viral Hepat 2007, 14:89–96.

    Article  PubMed  Google Scholar 

  24. Cameron AM, Ghobrial RM, Hiatt JR, et al.: Effect of nonviral factors on hepatitis C recurrence after liver transplantation. Ann Surg 2006, 244:563–571.

    Article  PubMed  Google Scholar 

  25. Onaca NN, Levy MF, Netto GJ, et al.: Pretransplant MELD score as a predictor of outcome after liver transplantation for chronic hepatitis C. Am J Transplant 2003, 3:626–630.

    Article  PubMed  Google Scholar 

  26. Briceño J, Ciria R, Pleguezuelo M, et al.: Contribution of marginal donors to liver transplantation for hepatitis C virus infection. Transplant Proc 2007, 39:2297–2299.

    Article  PubMed  Google Scholar 

  27. Botha JF, Thompson E, Gilroy R, et al.: Mild donor liver steatosis has no impact on hepatitis C virus fibrosis progression following liver transplantation. Liver Int 2007, 27:758–763.

    Article  PubMed  Google Scholar 

  28. Rayhill SC, Wu YM, Katz DA, et al.: Older donor livers show early severe histological activity, fibrosis, and graft failure after liver transplantation for hepatitis C. Transplantation 2007, 84:331–339.

    Article  PubMed  Google Scholar 

  29. Belli LS, Burroughs AK, Burra P, et al.: Liver transplantation for HCV cirrhosis: improved survival in recent years and increased severity of recurrent disease in female recipients: results of a long term retrospective study. Liver Transpl 2007, 13:733–740.

    Article  PubMed  Google Scholar 

  30. Gaglio PJ, Malireddy S, Levitt BS, et al.: Increased risk of cholestatic hepatitis C in recipients of grafts from living versus cadaveric liver donors. Liver Transpl 2003, 9:1028–1035.

    Article  PubMed  Google Scholar 

  31. Terrault NA, Shiffman ML, Lok AS, et al.: A2ALL Study Group: Outcomes in hepatitis C virus-infected recipients of living donor vs. deceased donor liver transplantation. Liver Transpl 2007, 13:122–129.

    Article  PubMed  Google Scholar 

  32. Lee KW, Simpkins CE, Montgomery RA, et al.: Factors affecting graft survival after liver transplantation from donation after cardiac death donors. Transplantation 2006, 82:1683–1688.

    Article  PubMed  Google Scholar 

  33. Dezza MC, Berrevoet F, Sainz-Barriga M, et al.: The choice of recipient does not have a bearing on early outcome in liver transplant patients receiving grafts from non-heart-beating donors: a reappraisal? Transplant Proc 2007, 39:2675–2677.

    Article  PubMed  Google Scholar 

  34. Katz LH, Mor E, Brown M, et al.: Recurrent hepatitis C virus disease after liver transplantation and concurrent biliary tract complications: poor outcome. Clin Transplant 2006, 20:465–470.

    Article  PubMed  Google Scholar 

  35. Klintmalm GB, Washburn WK, Rudich SM, et al.: Corticosteroid-free immunosuppression with daclizumab in HCV(+) liver transplant recipients: 1-year interim results of the HCV-3 study. Liver Transpl 2007, 13:1521–1531.

    Article  PubMed  Google Scholar 

  36. Vivarelli M, Burra P, Barba GL, et al.: Influence of steroids on HCV recurrence after liver transplantation: a prospective study. J Hepatol 2007, 47:793–798.

    Article  PubMed  CAS  Google Scholar 

  37. Berenguer M, Royuela A, Zamora J: Immunosuppression with calcineurin inhibitors with respect to the outcome of HCV recurrence after liver transplantation: results of a meta-analysis. Liver Transpl 2007, 13:21–29.

    Article  PubMed  Google Scholar 

  38. Guitard J, Sandres-Sauné K, Kamar N: Hepatitis C virus viral load after conversion from tacrolimus to cyclosporine in liver transplant patients. Transplant Proc 2007, 39:2603–2605.

    Article  PubMed  CAS  Google Scholar 

  39. Bahra M, Neumann UP, Jacob D, et al.: Repeated steroid pulse therapies in HCV-positive liver recipients. Transplant Proc 2005, 37:1700–1702.

    Article  PubMed  CAS  Google Scholar 

  40. Wiesner RH, Shorr JS, Steffen BJ, et al.: Mycophenolate mofetil combination therapy improves long-term outcomes after liver transplantation in patients with and without hepatitis C. Liver Transpl 2005, 11:750–759.

    Article  PubMed  Google Scholar 

  41. Kwo PY, Saxena R, Cummings OW, et al.: Intravenous interferon during the anhepatic phase of liver retransplantation and prevention of recurrence of cholestatic hepatitis C virus. Liver Transpl 2007, 13:1710–1713.

    Article  PubMed  Google Scholar 

  42. Arjal RR, Burton JR Jr, Villamil F, et al.: Review article: the treatment of hepatitis C virus recurrence after liver transplantation. Aliment Pharmacol Ther 2007, 26:127–140.

    Article  PubMed  CAS  Google Scholar 

  43. Wiesner RH, Sorrell M, Villamil F, et al.: Report of the first International Liver Transplantation Society expert panel consensus conference on liver transplantation and hepatitis C. Liver Transpl 2003, 9:S1–S9.

    Article  PubMed  Google Scholar 

  44. Saab S, Oh MK, Ibrahim AB, et al.: Anemia in liver transplant recipients undergoing antiviral treatment for recurrent hepatitis C. Liver Transpl 2007, 13:1032–1038.

    Article  PubMed  Google Scholar 

  45. Schecter JM, Mears JG, Alobeid B, et al.: Anti-erythropoietin antibody-mediated pure red cell alpasia in a living donor liver transplant recipient treated for hepatitis C virus. Liver Transpl 2007, 13:1589–1592.

    Article  PubMed  Google Scholar 

  46. Picciotto FP, Tritto G, Lanza AG, et al.: Sustained virological response to antiviral therapy reduces mortality in HCV reinfection after liver transplantation. J Hepatol 2007, 46:459–465.

    Article  PubMed  CAS  Google Scholar 

  47. Kornberg A, Küpper B, Tannapfel A, et al.: Antiviral maintenance treatment with interferon and ribavirin for recurrent hepatitis C after liver transplantation: pilot study. J Gastroenterol Hepatol 2007, 22:2135–2142.

    Article  PubMed  CAS  Google Scholar 

  48. McCashland T, Watt K, Lyden E, et al.: Retransplantation for heaptitis C: results of a U.S. multicenter retransplant study. Liver Transpl 2007, 13:1246–1253.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Paul J. Gaglio.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fink, S., Gaglio, P.J. Hepatitis C in liver transplant patients. Curr hepatitis rep 7, 81–87 (2008). https://doi.org/10.1007/s11901-008-0012-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11901-008-0012-4

Keywords

Navigation