Skip to main content
SpringerLink
Log in

Management of Hepatitis C Infection after Liver Transplantation

  • Therapy In Practice
  • Published:
Drugs Aims and scope Submit manuscript

Abstract

Recurrent hepatitis C virus (HCV) infection after orthotopic liver transplantation (OLT) has been associated with progression to cirrhosis in ≈20% of patients, 5 years postoperatively. Accelerated decompensation has also been noted when compared with cirrhosis in non-transplant patients. Different treatment strategies are available for recurrent HCV infection post-OLT, but efforts are hindered by the modest response rates, poor tolerability and the risk of rejection as well as graft loss.

Anti-HCV immunoglobulin therapy to prevent graft infection with HCV has no established role at present but studies are ongoing. Treatment prior to transplantation in patients with decompensated cirrhosis has been evaluated but the results are too preliminary to make firm recommendations. Prophylactic interferon-based antiviral therapy in the early postoperative period to prevent graft infection was shown to have low response rates and high rates of adverse effects. Treatment of established recurrent HCV infection with combination peginterferon (pegylated interferon) and ribavirin is associated with 10–59% sustained virological response and the predictive value of a positive early virological response has been validated in the post-transplant setting. Improvement in inflammatory activity after viral eradication is well established, but fibrosis regression or stabilisation is less predictable and factors such as rejection and biliary complications may still contribute to graft loss. Most studies have initiated therapy at least 6 months postoperatively in order to optimise patient tolerance and enable the addition of ribavirin. The use of adjuvant agents to treat drug-induced neutropenia and anaemia in this population is evolving and becoming a crucial part of therapy. Determination of optimal doses of both pegylated interferon and ribavirin, and guidance on when to stop treatment, as well as improving tolerability are important steps in achieving higher response rates and minimising drug toxicity.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Table I
Table II

Similar content being viewed by others

References

  1. Belle SH, Beringer KC, Detre KM. Recent findings concerning liver transplantation in the United States. Clin Transpl 1996:15-29

  2. Forman LM, Lewis JD, Berlin JA, et al. The association between hepatitis C infection and survival after orthotopic liver transplantation. Gastroenterology 2002 Apr; 122 (4): 889–96

    Article  PubMed  Google Scholar 

  3. Berenguer M, Rayon JM, Prieto M, et al. Are posttransplantation protocol liver biopsies useful in the long term? Liver Transpl 2001 Sep; 7 (9): 790–6

    Article  PubMed  CAS  Google Scholar 

  4. Berenguer M, Lopez-Labrador FX, Wright TL. Hepatitis C and liver transplantation. J Hepatol 2001 Nov; 35 (5): 666–78

    Article  PubMed  CAS  Google Scholar 

  5. Charlton M, Seaberg E, Wiesner R, et al. Predictors of patient and graft survival following liver transplantation for hepatitis C. Hepatology 1998 Sep; 28 (3): 823–30

    Article  PubMed  CAS  Google Scholar 

  6. Fukumoto T, Berg T, Ku Y, et al. Viral dynamics of hepatitis C early after orthotopic liver transplantation: evidence for rapid turnover of serum virions. Hepatology 1996 Dec; 24 (6): 1351–4

    Article  PubMed  CAS  Google Scholar 

  7. Gane EJ, Portmann BC, Naoumov NV, et al. Long-term outcome of hepatitis C infection after liver transplantation. N Engl J Med 1996 Mar 28; 334 (13): 815–20

    Article  PubMed  CAS  Google Scholar 

  8. Gane EJ, Naoumov NV, Qian KP, et al. A longitudinal analysis of hepatitis C virus replication following liver transplantation. Gastroenterology 1996 Jan; 110 (1): 167–77

    Article  PubMed  CAS  Google Scholar 

  9. Prieto M, Berenguer M, Rayon JM, et al. High incidence of allograft cirrhosis in hepatitis C virus genotype 1b infection following transplantation: relationship with rejection episodes. Hepatology 1999 Jan; 29 (1): 250–6

    Article  PubMed  CAS  Google Scholar 

  10. Sanchez-Fueyo A, Restrepo JC, Quinto L, et al. Impact of the recurrence of hepatitis C virus infection after liver transplantation on the long-term viability of the graft. Transplantation 2002 Jan 15; 73 (1): 56–63

    Article  PubMed  Google Scholar 

  11. Bahra M, Neumann UP, Jacob D, et al. Repeated steroid pulse therapies in HCV-positive liver recipients: significant risk factor for HCV-related graft loss. Transplant Proc 2005 May; 37 (4): 1700–2

    Article  PubMed  CAS  Google Scholar 

  12. Berenguer M. Natural history of recurrent hepatitis C. Liver Transpl 2002 Oct; 8 (10 Suppl. 1): S14–18

    Article  PubMed  Google Scholar 

  13. Berenguer M, Prieto M, San Juan F, et al. Contribution of donor age to the recent decrease in patient survival among HCV-infected liver transplant recipients [erratum appears in Hepatology 2003 Feb; 37 (2): 489]. Hepatology 2002 Jul; 36 (1): 202–10

    Article  PubMed  Google Scholar 

  14. Neumann UP, Berg T, Bahra M, et al. Fibrosis progression after liver transplantation in patients with recurrent hepatitis C. J Hepatol 2004 Nov; 41 (5): 830–6

    Article  PubMed  CAS  Google Scholar 

  15. Testa G, Crippin JS, Netto GJ, et al. Liver transplantation for hepatitis C: recurrence and disease progression in 300 patients. Liver Transpl 2000 Sep; 6 (5): 553–61

    Article  PubMed  CAS  Google Scholar 

  16. Zhou S, Terrault NA, Ferrell L, et al. Severity of liver disease in liver transplantation recipients with hepatitis C virus infection: relationship to genotype and level of viremia. Hepatology 1996 Nov; 24 (5): 1041–6

    Article  PubMed  CAS  Google Scholar 

  17. Papatheodoridis GV, Davies S, Dhillon AP, et al. The role of different immunosuppression in the long-term histological outcome of HCV reinfection after liver transplantation for HCV cirrhosis. Transplantation 2001 Aug 15; 72 (3): 412–8

    Article  PubMed  CAS  Google Scholar 

  18. Martin P, Busuttil RW, Goldstein RM, et al. Impact of tacrolimus versus cyclosporine in hepatitis C virus-infected liver transplant recipients on recurrent hepatitis: a prospective, randomized trial. Liver Transpl 2004 Oct; 10 (10): 1258–62

    Article  PubMed  Google Scholar 

  19. Firpi RJ, Zhu H, Morelli G, et al. Cyclosporine suppresses hepatitis C virus in vitro and increases the chance of a sustained virological response after liver transplantation. Liver Transpl 2006 Jan; 12 (1): 51–7

    Article  PubMed  Google Scholar 

  20. Selzner N, Girgrah N, Al Adawi I, et al. Genotype and choice of calcineurin inhibitor influence response to antiviral therapy in liver transplant recipients treated for recurrent HCV [abstract]. Hepatology 2006; 44 (4 Suppl. 1): A785

    Google Scholar 

  21. Berenguer M, Palau A, Fernandez A, et al. Efficacy, predictors of response, and potential risks associated with antiviral therapy in liver transplant recipients with recurrent hepatitis C. Liver Transpl 2006 Jul; 12 (7): 1067–76

    Article  PubMed  Google Scholar 

  22. Eason JD, Nair S, Cohen AJ, et al. Steroid-free liver transplantation using rabbit antithymocyte globulin and early tacrolimus monotherapy. Transplantation 2003 Apr 27; 75 (8): 1396–9

    Article  PubMed  CAS  Google Scholar 

  23. Filipponi F, Callea F, Salizzoni M, et al. Double-blind comparison of hepatitis C histological recurrence rate in HCV+ liver transplant recipients given basiliximab + steroids or basiliximab + placebo, in addition to cyclosporine and azathioprine. Transplantation 2004 Nov 27; 78 (10): 1488–95

    Article  PubMed  CAS  Google Scholar 

  24. Langrehr JM, Neumann UP, Lang M, et al. First results from a prospective randomized trial comparing steroid-free induction therapy with tacrolimus and MMF versus tacrolimus and steroids in patients after liver transplantation for HCV. Transplantation Proc 2002 Aug; 34 (5): 1565–6

    Article  CAS  Google Scholar 

  25. Llado L, Xiol X, Figueras J, et al. Immunosuppression without steroids in liver transplantation is safe and reduces infection and metabolic complications: results from a prospective multicenter randomized study. J Hepatol 2006 Apr; 44 (4): 710–6

    Article  PubMed  CAS  Google Scholar 

  26. Margarit C, Bilbao I, Castells L, et al. A prospective randomized trial comparing tacrolimus and steroids with tacrolimus monotherapy in liver transplantation: the impact on recurrence of hepatitis C. Transplant Int 2005 Dec; 18 (12): 1336–45

    Article  CAS  Google Scholar 

  27. Nair S, Loss GE, Cohen AJ, et al. Induction with rabbit antithymocyte globulin versus induction with corticosteroids in liver transplantation: impact on recurrent hepatitis C virus infection. Transplantation 2006 Feb 27; 81 (4): 620–2

    Article  PubMed  CAS  Google Scholar 

  28. Wietzke-Braun P, Braun F, Sattler B, et al. Initial steroid-free immunosuppression after liver transplantation in recipients with hepatitis C virus related cirrhosis. World J Gastroenterol 2004 Aug 1; 10 (15): 2213–7

    PubMed  Google Scholar 

  29. Sheiner PA, Schwartz ME, Mor E, et al. Severe or multiple rejection episodes are associated with early recurrence of hepatitis C after orthotopic liver transplantation. Hepatology 1995 Jan; 21 (1): 30–4

    Article  PubMed  CAS  Google Scholar 

  30. Calmus Y, Scheele JR, Gonzalez-Pinto I, et al. Immunoprophylaxis with basiliximab, a chimeric anti-interleukin-2 receptor monoclonal antibody, in combination with azathioprine-containing triple therapy in liver transplant recipients. Liver Transpl 2002 Feb; 8 (2): 123–31

    Article  PubMed  Google Scholar 

  31. Hirose R. Pros and cons of using interleukin-2 receptor antibodies in liver transplant recipients. Liver Transpl 2002 Feb; 8 (2): 143–5

    Article  PubMed  Google Scholar 

  32. Neuhaus P, Clavien P-A, Kittur D, et al. Improved treatment response with basiliximab immunoprophylaxis after liver transplantation: results from a double-blind randomized placebo-controlled trial. Liver Transpl 2002 Feb; 8 (2): 132–42

    Article  PubMed  Google Scholar 

  33. Jain A, Kashyap R, Demetris AJ, et al. A prospective randomized trial of mycophenolate mofetil in liver transplant recipients with hepatitis C. Liver Transpl 2002 Jan; 8 (1): 40–6

    Article  PubMed  Google Scholar 

  34. Wiesner R, Rabkin J, Klintmalm G, et al. A randomized double-blind comparative study of mycophenolate mofetil and azathioprine in combination with cyclosporine and corticosteroids in primary liver transplant recipients. Liver Transpl 2001 May; 7 (5): 442–50

    Article  PubMed  CAS  Google Scholar 

  35. Berenguer M, Crippin J, Gish R, et al. A model to predict severe HCV-related disease following liver transplantation. Hepatology 2003 Jul; 38 (1): 34–41

    Article  PubMed  Google Scholar 

  36. 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 Jul; 11 (7): 750–9

    Article  PubMed  Google Scholar 

  37. Berenguer M. Live donor liver transplantation for hepatitis C: new data, old story. Liver Transpl 2006 Apr; 12 (4): 516–9

    Article  PubMed  Google Scholar 

  38. Guo L, Orrego M, Rodriguez-Luna H, et al. Living donor liver transplantation for hepatitis C-related cirrhosis: no difference in histological recurrence when compared to deceased donor liver transplantation recipients. Liver Transpl 2006 Apr; 12 (4): 560–5

    Article  PubMed  Google Scholar 

  39. Garcia-Retortillo M, Forns X, Llovet JM, et al. Hepatitis C recurrence is more severe after living donor compared to cadaveric liver transplantation. Hepatology 2004 Sep; 40 (3): 699–707

    Article  PubMed  Google Scholar 

  40. Thuluvath PJ, Yoo HY. Graft and patient survival after adult live donor liver transplantation compared to a matched cohort who received a deceased donor transplantation. Liver Transpl 2004 Oct; 10 (10): 1263–8

    Article  PubMed  Google Scholar 

  41. 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 Oct; 9 (10): 1028–35

    Article  PubMed  Google Scholar 

  42. Bozorgzadeh A, Jain A, Ryan C, et al. Impact of hepatitis C viral infection in primary cadaveric liver allograft versus primary living-donor allograft in 100 consecutive liver transplant recipients receiving tacrolimus [erratum appears in Transplantation 2004 Jun 27; 77 (12): 1920]. Transplantation 2004 Apr 15; 77 (7): 1066–70

    Article  PubMed  CAS  Google Scholar 

  43. Russo MW, Galanko J, Beavers K, et al. Patient and graft survival in hepatitis C recipients after adult living donor liver transplantation in the United States. Liver Transpl 2004 Mar; 10 (3): 340–6

    Article  PubMed  Google Scholar 

  44. Shiftman ML, Stravitz RT, Contos MJ, et al. Histologic recurrence of chronic hepatitis C virus in patients after living donor and deceased donor liver transplantation. Liver Transpl 2004 Oct; 10 (10): 1248–55

    Article  Google Scholar 

  45. Ferrell LD, Wright TL, Roberts J, et al. Hepatitis C viral infection in liver transplant recipients. Hepatology 1992 Oct; 16 (4): 865–76

    Article  PubMed  CAS  Google Scholar 

  46. Scheuer P, Lefkowitch J. Liver biopsy interpretation. 6th ed. London: WB Saunders, 2002

    Google Scholar 

  47. Scheuer PJ, Ashrafzadeh P, Sherlock S, et al. The pathology of hepatitis C. Hepatology 1992 Apr; 15 (4): 567–71

    Article  PubMed  CAS  Google Scholar 

  48. Thung SN, Shim KS, Shieh YS, et al. Hepatitis C in liver allografts. Arch Pathol Lab Med 1993 Feb; 117 (2): 145–9

    PubMed  CAS  Google Scholar 

  49. Baiocchi L, Tisone G, Palmieri G, et al. Hepatic steatosis: a specific sign of hepatitis C reinfection after liver transplantation. Liver Transpl Surg 1998 Nov; 4 (6): 441–7

    Article  PubMed  CAS  Google Scholar 

  50. Gordon FD, Pomfret EA, Pomposelli JJ, et al. Severe steatosis as the initial histologic manifestation of recurrent hepatitis C genotype 3. Hum Pathol 2004 May; 35 (5): 636–8

    Article  PubMed  Google Scholar 

  51. Dhillon AP, Dusheiko GM. Pathology of hepatitis C virus infection. Histopathology 1995 Apr; 26 (4): 297–309

    Article  PubMed  CAS  Google Scholar 

  52. Mueller AR, Platz KP, Berg T, et al. Association between hepatitis and rejection: upregulation of cytokines and extracellular matrix parameters. Transpl Proc 1997 Nov; 29 (7): 2843–5

    Article  CAS  Google Scholar 

  53. Petrovic LM, Villamil FG, Vierling JM, et al. Comparison of histopathology in acute allograft rejection and recurrent hepatitis C infection after liver transplantation. Liver Transpl Surg 1997 Jul; 3 (4): 398–406

    Article  PubMed  CAS  Google Scholar 

  54. Regev A, Molina E, Moura R, et al. Reliability of histopathologic assessment for the differentiation of recurrent hepatitis C from acute rejection after liver transplantation. Liver Transpl 2004 Oct; 10 (10): 1233–9

    Article  PubMed  Google Scholar 

  55. Neff GW, Shire N, Ruiz P, et al. The importance of clinical parameters when differentiating cholestatic hepatitis C virus from allograft rejection. Transpl Proc 2005 Dec; 37 (10): 4397–402

    Article  CAS  Google Scholar 

  56. 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 Nov; 9 (11): S1–9

    Article  PubMed  Google Scholar 

  57. Firpi RJ, Abdelmalek MF, Soldevila-Pico C, et al. One-year protocol liver biopsy can stratify fibrosis progression in liver transplant recipients with recurrent hepatitis C infection. Liver Transpl 2004 Oct; 10 (10): 1240–7

    Article  PubMed  Google Scholar 

  58. Carrion JA, Navasa M, Bosch J, et al. Transient elastography to evaluate the severity of hepatitis C recurrence after liver transplantation. J Hepatol 2006; 44 Suppl. 2: S37

    Article  Google Scholar 

  59. Corradi F, Piscaglia F, Tame R, et al. Staging of hepatic fibrosis by liver elastometry (fibroscan) in recurrent HCV infection in liver transplant recipients. J Hepatol 2006; 44 Suppl. 2: S59

    Article  Google Scholar 

  60. Firpi RJ, Abdelmalek MF, Soldevila-Pico C, et al. Combination of interferon -2b and ribavirin in liver transplant recipients with histological recurrent hepatitis C. Liver Transpl 2002 Nov; 8 (11): 1000–6

    Article  PubMed  Google Scholar 

  61. Stravitz RT, Shiffman ML, Sanyal AJ, et al. Effects of interferon treatment on liver histology and allograft rejection in patients with recurrent hepatitis C following liver transplantation. Liver Transpl 2004; 10 (7): 850–8

    Article  PubMed  Google Scholar 

  62. Feray C, Samuel D, Gigou M, et al. An open trial of interferon alfa recombinant for hepatitis C after liver transplantation: antiviral effects and risk of rejection. Hepatology 1995 Oct; 22 (4 Pt 1): 1084–9

    Article  PubMed  CAS  Google Scholar 

  63. Saab S, Kalmaz D, Gajjar NA, et al. Outcomes of acute rejection after interferon therapy in liver transplant recipients. Liver Transpl 2004; 10 (7): 859–67

    Article  PubMed  Google Scholar 

  64. Davis GL, Nelson DR, Terrault N, et al. A randomized, open-label study to evaluate the safety and pharmacokinetics of human hepatitis C immune globulin (Civacir) in liver transplant recipients. Liver Transpl 2005 Aug; 11 (8): 941–9

    Article  PubMed  Google Scholar 

  65. Eren R, Landstein D, Terkieltaub D, et al. Preclinical evaluation of two neutralizing human monoclonal antibodies against hepatitis C virus (HCV): a potential treatment to prevent HCV reinfection in liver transplant patients. J Virol 2006 Mar; 80 (6): 2654–64

    Article  PubMed  CAS  Google Scholar 

  66. Crippin JS, McCashland T, Terrault N, et al. A pilot study of the tolerability and efficacy of antiviral therapy in hepatitis C virus-infected patients awaiting liver transplantation. Liver Transpl 2002 Apr; 8 (4): 350–5

    Article  PubMed  Google Scholar 

  67. Everson GT, Trotter J, Forman L, et al. Treatment of advanced hepatitis C with a low accelerating dosage regimen of antiviral therapy. Hepatology 2005 Aug; 42 (2): 255–62

    Article  PubMed  CAS  Google Scholar 

  68. Forns X, Garcia-Retortillo M, Serrano T, et al. Antiviral therapy of patients with decompensated cirrhosis to prevent recurrence of hepatitis C after liver transplantation. J Hepatol 2003 Sep; 39 (3): 389–96

    Article  PubMed  CAS  Google Scholar 

  69. Martinez-Bauer E, Carrion JA, Ramirez S, et al. Antiviral therapy of patients with decompensated cirrhosis to prevent hepatitis C recurrence after liver transplantation. J Hepatol 2006; 44 Suppl. 2: S64

    Article  Google Scholar 

  70. Thomas RM, Brems JJ, Guzman-Hartman G, et al. Infection with chronic hepatitis C virus and liver transplantation: a role for interferon therapy before transplantation. Liver Transpl 2003 Sep; 9 (9): 905–15

    Article  PubMed  Google Scholar 

  71. Zileri Dal Verme L, Ilyas JA, Merra G, et al. HCV treatment in patients with end stage liver disease awaiting liver transplantation. J Hepatol 2006; 44 Suppl. 2: S232

    Article  Google Scholar 

  72. Sheiner PA, Boros P, Klion FM, et al. The efficacy of prophylactic interferon alfa-2b in preventing recurrent hepatitis C after liver transplantation. Hepatology 1998 Sep; 28 (3): 831–8

    Article  PubMed  CAS  Google Scholar 

  73. Singh N, Gayowski T, Wannstedt CF, et al. Interferon-alpha for prophylaxis of recurrent viral hepatitis C in liver transplant recipients: a prospective, randomized, controlled trial. Transplantation 1998 Jan 15; 65 (1): 82–6

    Article  PubMed  CAS  Google Scholar 

  74. Mazzaferro V, Tagger A, Schiavo M, et al. Prevention of recurrent hepatitis C after liver transplantation with early interferon and ribavirin treatment. Transpl Proc 2001 Feb–Mar; 33 (1–2): 1355–7

    Article  CAS  Google Scholar 

  75. Shergill AK, Khalili M, Straley S, et al. Applicability, tolerability and efficacy of preemptive antiviral therapy in hepatitis C-infected patients undergoing liver transplantation. Am J Transpl 2005 Jan; 5 (1): 118–24

    Article  Google Scholar 

  76. Reddy KR, Fried MW, Dickson RC, et al. Interferon alfa-2b and ribavirin vs. placebo as early treatment in patients transplanted for hepatitis C end-stage liver disease: results of a multicenter, randomized trial [abstract no. A199]. Gastroenterology 2002, 122

  77. Chalasani N, Manzarbeitia C, Ferenci P, et al. Peginterferon alfa-2a for hepatitis C after liver transplantation: two randomized, controlled trials [erratum appears in Hepatology 2005 Aug; 42 (2): 506]. Hepatology 2005 Feb; 41 (2): 289–98

    Article  PubMed  CAS  Google Scholar 

  78. Kuo A, Lan B, Feng S, et al. Long-term histological effects of preemptive antiviral therapy in liver transplant recipients with hepatitis c virus (HCV) infection [abstract]. Hepatology 2006; 44 (4 Suppl. 1): A3

    Article  Google Scholar 

  79. Petrolati A, Lionetti R, Lenci I, et al. PEG-interferon a-2a (40kd) with or without ribavirin in the treatment of naive patients with recurrent hepatitis C after liver transplantation [abstract]. Hepatology 2005; 42 (4 Suppl. 1): A726

    Google Scholar 

  80. Moreno Planas JM, Rubio Gonzalez E, Boullosa Grana E, et al. Peginterferon and ribavirin in patients with HCV cirrhosis after liver transplantation. Transpl Proc 2005 Jun; 37 (5): 2207–8

    Article  CAS  Google Scholar 

  81. Duvoux C, Samuel D, Pageaux G, et al. Multicenter randomized trial of HCV treatment with peginterferon-alpha 2a and ribavirin in liver transplant patients with established recurrent hepatitis C: interim analysis. J Hepatol 2006; 44 Suppl. 2: S3

    Article  Google Scholar 

  82. Samuel D, Bizollon T, Feray C, et al. Interferon-alpha 2b plus ribavirin in patients with chronic hepatitis C after liver transplantation: a randomized study. Gastroenterology 2003 Mar; 124 (3): 642–50

    Article  PubMed  CAS  Google Scholar 

  83. Abdelmalek MF, Firpi RJ, Soldevila-Pico C, et al. Sustained viral response to interferon and ribavirin in liver transplant recipients with recurrent hepatitis C. Liver Transpl 2004 Feb; 10 (2): 199–207

    Article  PubMed  Google Scholar 

  84. Bizollon T, Ahmed SNS, Radenne S, et al. Long term histological improvement and clearance of intrahepatic hepatitis C virus RNA following sustained response to interferon-ribavirin combination therapy in liver transplanted patients with hepatitis C virus recurrence. Gut 2003 Feb; 52 (2): 283–7

    Article  PubMed  CAS  Google Scholar 

  85. Dumortier J, Scoazec JY, Chevallier P, et al. Treatment of recurrent hepatitis C after liver transplantation: a pilot study of peginterferon alfa-2b and ribavirin combination. J Hepatol. 2004 Apr; 40 (4): 669–74

    Article  PubMed  CAS  Google Scholar 

  86. Ghalib R, Levine C, Hollinger B, et al. Sustained viral response using PEG IFN ALFA-2B plus ribavirin in patients with recurrent heaptitis C after liver transplantation [abstract]. Hepatology 2006; 44 (4 Suppl. 1): A778

    Google Scholar 

  87. Picciotto F, Lanza A, De Luca M, et al. Pegylated-interferon alpha-2b plus ribavirin in the treatment of HCV reinfection after liver transplantation experience of a single centre [abstract]. J Hepatol 2005; 42 Suppl. 2: A140

    Google Scholar 

  88. Iacob S, Beckebaum S, Cicinnati V, et al. 580 Predictive factors of sustained virological and histological response after combination antiviral therapy in transplanted patients with recurrent hepatitis C. J Hepatol 2006; 44 Suppl. 2: S215

    Article  Google Scholar 

  89. Martini S, Lavezzo B, Saettone S, et al. Pegylated interferon (PEG-IFN) alpha-2b + ribavirin (RB) in the treatment of post-liver transplant (LT) recurrent hepatitis C [abstract]. J Hepatol 2005; 42 Suppl. 2: A131

    Google Scholar 

  90. Casanovas-Taltavull T, Llobet M, Casanova A, et al. Predictive factors of early and sustained viral response in patients with recurrent hepatitis C after liver transplantation treated with combined therapy (IFN-alpha and ribavirin) [abstract]. Hepatology 2005; 42 (4 Suppl. 1): A738

    Google Scholar 

  91. Neumann U, Puhl G, Bahra M, et al. Treatment of patients with recurrent hepatitis C after liver transplantation with peginterferon alfa-2B plus ribavirin. Transplantation 2006 Jul 15; 82 (1): 43–7

    Article  PubMed  CAS  Google Scholar 

  92. Burra P, Targhetta S, Pevere S, et al. Antiviral therapy for hepatitis C virus recurrence following liver transplantation: long-term results from a single center experience. Transpl Proc 2006 May; 38 (4): 1127–30

    Article  CAS  Google Scholar 

  93. Biselli M, Andreone P, Gramenzi A, et al. Pegylated interferon plus ribavirin for recurrent hepatitis C infection after liver transplantation in naive and non-responder patients on a stable immunosuppressive regimen. Dig Liver Dis 2006 Jan; 38 (1): 27–32

    Article  PubMed  CAS  Google Scholar 

  94. Mukherjee S. Pegylated interferon alfa-2a and ribavirin for recurrent hepatitis C after liver transplantation. Transpl Proc 2005 Dec; 37 (10): 4403–5

    Article  CAS  Google Scholar 

  95. Bahra M, Neumann P, Jacob D, et al. Long term results after therapy with egylated interferon alpha 2a in HCV positive liver transplant recipients [abstract]. Hepatology 2005; 42 (4 Suppl. 1): A742

    Google Scholar 

  96. Lilly L, Girgrah N, Al Alwan A, et al. On treatment virological response of 70% in 100 patients treated with combination antiviral therapy for recurrent HCV following liver transplantation [abstract]. Hepatology 2005; 42 (4 Suppl. 1): A744

    Google Scholar 

  97. Anonymous. Intraobserver and interobserver variations in liver biopsy interpretation in patients with chronic hepatitis C. The French METAVIR Cooperative Study Group. Hepatology 1994; 20 (1): 15–20

  98. Petrolati A, Lionetti R, Donate F, et al. PEG interferon alfa-2a (40KD) with or without ribavirin in the treatment of recurrent hepatitis C after liver transplantation: preliminary report of a randomized study [abstract]. J Hepatol 2004; 40 Suppl. 1: A100

    Google Scholar 

  99. Chacko K, Sussman N, Vierling J, et al. Adherence to the 80/80/80 rule in treatment of HCV recurrence after OLT is strongly Associated with sustained virologic response (SVR) [abstract]. Hepatology 2006; 44 (4 Suppl. 1): A789

    Google Scholar 

  100. Jarvis SM, Thorn JA, Glue P. Ribavirin uptake by human erythrocytes and the involvement of nitrobenzylthioinosine-sensitive (es)-nucleoside transporters. Br J Pharmacol 1998 Apr; 123 (8): 1587–92

    Article  PubMed  CAS  Google Scholar 

  101. Dumortier J, Ducos E, Scoazec JY, et al. Plasma ribavirin concentrations during treatment of recurrent hepatitis C with peginterferon alpha-2b and ribavirin combination after liver transplantation. J Viral Hepatitis 2006 Aug; 13 (8): 538–43

    Article  CAS  Google Scholar 

  102. Gopal DV, Rosen HR. Duration of antiviral therapy for cholestatic HCV recurrence may need to be indefinite. Liver Transpl 2003 Apr; 9 (4): 348–53

    Article  PubMed  Google Scholar 

  103. Kwo P, Saxena R, Cummings O, et al. Intravenous interferon during the anhepatic phase of liver transplantation and prevention of recurrence of cholestatic HCV. Liver Transpl 2007. In press

  104. Paterson DL, Gayowski T, Wannstedt CF, et al. Quality of life in long-term survivors after liver transplantation: impact of recurrent viral hepatitis C virus hepatitis. Clin Transpl 2000 Feb; 14 (1): 48–54

    Article  CAS  Google Scholar 

  105. Singh N, Gayowski T, Wagener MM, et al. Quality of life, functional status, and depression in male liver transplant recipients with recurrent viral hepatitis C. Transplantation 1999 Jan 15; 67 (1): 69–72

    Article  PubMed  CAS  Google Scholar 

  106. Azoulay D, Linhares MM, Huguet E, et al. Decision for retrans-plantation of the liver: an experience- and cost-based analysis. Ann Surg 2002 Dec; 236 (6): 713–21

    Article  PubMed  Google Scholar 

  107. Roayaie S, Schiano TD, Thung SN, et al. Results of retrans-plantation for recurrent hepatitis C. Hepatology 2003 Dec; 38 (6): 1428–36

    PubMed  Google Scholar 

  108. Neff GW, O’Brien CB, Nery J, et al. Factors that identify survival after liver retransplantation for allograft failure caused by recurrent hepatitis C infection. Liver Transpl 2004 Dec; 10 (12): 1497–503

    Article  PubMed  Google Scholar 

  109. Burton JR, Sonnenberg A, Rosen HR. Retransplantation for recurrent hepatitis C in the MELD era: maximizing utility. Liver Transpl 2004 Oct; 10 (10 Suppl. 2): S59–64

    Article  PubMed  Google Scholar 

  110. Ghobrial RM. Retransplantation for recurrent hepatitis C. Liver Transpl 2002 Oct; 8 (10 Suppl. 1): S38–43

    Article  PubMed  Google Scholar 

  111. Rosen HR, Prieto M, Casanovas-Taltavull T, et al. Validation and refinement of survival models for liver retransplantation. Hepatology 2003 Aug; 38 (2): 460–9

    Article  PubMed  Google Scholar 

  112. Yao FY, Saab S, Bass NM, et al. Prediction of survival after liver retransplantation for late graft failure based on preoperative prognostic scores. Hepatology 2004 Jan; 39 (1): 230–8

    Article  PubMed  Google Scholar 

  113. Llado L, Castellote J, Figueras J. Is retransplantation an option for recurrent hepatitis C cirrhosis after liver transplantation? J Hepatol 2005 Apr; 42 (4): 468–72

    Article  PubMed  Google Scholar 

  114. McCashland TM. Retransplantation for recurrent hepatitis C: positive aspects. Liver Transpl 2003; 9 (11): S67–72

    Article  PubMed  Google Scholar 

  115. Wall WJ, Khakhar A. Retransplantation for recurrent hepatitis C: the argument against. Liver Transpl 2003; 9 (11): S73–8

    Article  PubMed  Google Scholar 

  116. Castells L, Vargas V, Allende H, et al. Combined treatment with pegylated interferon (alpha-2b) and ribavirin in the acute phase of hepatitis C virus recurrence after liver transplantation. J Hepatol 2005 Jul; 43 (1): 53–9

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

Drs Alsatie and Chalasani have no conflicts of interest to disclose. Dr Paul Kwo serves on the speaker’s bureau for various pharmaceutical companies with interest in hepatitis C therapeutics. This article was in part supported by NIH grant K24 DK 072101 (NC).

Author information

Authors and Affiliations

  1. Indiana University School of Medicine, WD OPW 2005, 1001 West 10th Street, Indianapolis, Indiana, 46202, USA

    Mazen Alsatie,  Naga Chalasani &  Paul Y. Kwo

Authors
  1. Mazen Alsatie
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Naga Chalasani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paul Y. Kwo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Naga Chalasani.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Alsatie, M., Chalasani, N. & Kwo, P.Y. Management of Hepatitis C Infection after Liver Transplantation. Drugs 67, 871–885 (2007). https://doi.org/10.2165/00003495-200767060-00004

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00003495-200767060-00004

Keywords

Search

Navigation