Abstract
To understand the clinical outcome of hepatitis C virus (HCV) recurrence, data from 35 liver transplant recipients who survived more than 6 months were reviewed. The presence of HCV-RNA was evaluated and genotyping was performed. On the basis of alanine aminotransferase (ALT) levels, patients were sorted into four groups. In 20 patients, a chronic elevation in ALT was found; HCV-RNA detection was positive in 17/17 and the following genotypes were found in 15 of them: lb in ten patients, 2a in four patients, and 3a in one patient. In 11 patients, ALT levels remained normal throughout follow-up; in nine of them HCV-RNA was positive; HCV genotyping was available in eight patients and identified type lb in two, type 2a in five, and type 3a in another patient. In two patients, ALT fluctuated above and below the upper limits of normality; type lb HCV-RNA was found in one of them. In two patients, after an initial period of normality, ALT levels showed an abrupt rise; HCV-RNA was positive and type lb was identified in both patients. Eight patients developed HCV-related deep jaundice and three of them spontaneously recovered. Progressive hepatic injury occurred in eight patients, six with chronic ALT elevation and two showing a late ALT elevation; genotype lb was present in seven patients while in one, genotype 3a was found; sub-acute graft failure developed in five of them, leading to death in two and retransplantation in the others; the other three patients are alive with recurrent overt cirrhosis. The 1, 3, and 5 year actuarial survivals were 89%, 79%, and 63% respectively. The 1, 3, and 5 year actuarial risks of progressive graft damage were 6%, 7%, and 15%, respectively. In conclusion, HCV reinfection causes a slow decrease in the long-term patients’ survival. Persistent elevation of ALT is more frequently observed in patients with genotype lb infection.
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References
Ascher NL, Lake JR, Emond J, Roberts J (1994) Liver transplantation for hepatitis C virus related cirrhosis. Hepatology 20: 24S - 27S
Belli LS, Caccamo L, Mazzaferro V, Si-lini E, Alberti A, Melada E, Regalia E, Gridelli B, Rubino A, Gennari L, Gal- marini D, Ideo G, Belli L (1994) Milan multicenter experience in liver transplantation for hepatitis C related cirrhosis: report of 105 cases. Transplant Proc 26: 3582–3584
Caccamo L, Colledan M, Gridelli B, Rossi G, Doglia M, Gatti S, Ghidoni P, Lucianetti A, Lunghi G, Maggi G, Paone G, Reggiani P, Galmarini D, Fassati LR (1993) Hepatitis C virus infection in liver allografts recipients. Arch Virol Suppl 8: 291–304
Chazouilleres O, Kim M, Combs C, Ferrel L, Bacchetti P, Roberts J, Ascher NL, Neuwald P, Wilber J, Urdea M, Quan S, Sanchez-Pescador R, Wright TL (1994) Quantitation of hepatitis C virus RNA in liver transplant recipients. Gastroenterology 106: 994–999
Chomczynski P, Sacchi N (1987) Single-step method of RNA isolation by acid guanidinium-thiocyanate-phenol-chloroform extaction. Anal Biochem 162: 156–169
Donataccio M, Lerut J, Ciccarelli O, Cornu CH, Laterre PF, Geubel A, Otte JB (1994) Hepatitis C viral infection and adult liver transplantation: a difficult clinical problem. Transplant Proc 26: 3588–3590
Feray C, Gigou M, Samuel D, Paradis V, Wilber J, David MF, Urdea M, Reynes M, Brechot C, Bismuth H (1994) The course of hepatitis C virus infection after liver transplantation. Hepatology 20: 1137–1143
Feray C, Gigou M, Samuel D, Paradis V, Mishiro S, Maertens G, Reynes M, Okamoto H, Bismuth H, Brechot C (1995) Influence of genotypes of hepatitis C virus on the severity of recurrent liver disease after liver transplantation. Gastroenterology 108: 1088–1096
Ferrell LD, Wright TL, Roberts J, Ascher N, Lake J (1992) Hepatitis C viral infection in liver transplant recipients. Hepatology 16: 865–876
Gretch DR, Wilson JJ, Faulkner G, Corey L, Perkins J, Carithers RL (1994) Tracking hepatitis C virus quasispecies in liver transplant recipients (abstract). Hepatology 20: 132A
Gugenheim J, Baldini E, Mazza D, Fabiani P, St. Paul MC, Goubaux B, Ouzan D, Mouiel J (1994) Recurrence of hepatitis C virus after liver transplantation. Transplant Int 7 (suppl 1): S224 - S226
Knoop M, Lusebrink R, Langrehr JM, Konig F, Berg T, Wedell A, Hopf U, Neuhaus P (1994) Incidence and clinical relevance of recurrent hepatitis C infection after orthotopic liver transplantation. Transplant Int 7 (suppl 1): S221 - S223
Konig V, Bauditz J, Lobeck H, Lusebrink R, Neuhaus P, Blumhardt G, Bechstein WO, Neuhaus R, Steffen R, Hopf U (1992) Hepatitis C virus reinfection in allografts after orthotopic liver transplantation. Hepatology 16: 1137–1143
Li X, Jeffers L, Reddy R, De Medina M, Parker T, Schiff ER (1992) Detection of HCV-RNA by RT-PCR in lymphocyte subsets (abstract). Gastroenterology 102 (part 2): A842
Mateo R, Demetris A, Sico E, Frye C, Wang L-F, El-Sakhawi Y, Reilly M, Ehrlich GD, Cooper D, Fung J (1993) Early detection of de novo hepatitis C infection in patients after liver transplantation by reverse transcriptase polymerase reaction. Surgery 114: 442–448
Muller H, Otto G, Goeser T, Arnold J, Pfaff J, Thielmann L (1992) Recurrence of hepatitis C virus infection after orthotopic liver transplantation. Transplantation 54: 743–745
Nery J, Esquenazi V, Weppler D, Gomez C, Cirocco R, Gharagozloo H, Zucker K, Reddy R, Casella J, Parker I, Faria W, Jeffers L, Carreno M, Smith J, Markow M, Allouch M, Babischkin S, Bourke G, Hill M, Schiff E, LaRue S, Miller J (1994) Hepatitis C in liver transplantation: preliminary study of prognostic factors. Transplant Int 7 (suppl 1): S229 - S231
Pappo O, Ramos H, Starzl TE, Fung JJ, Demetris AJ (1995) Structural integrity and identification of causes of liver allograft dysfunction occurring more than 5 years after transplantation. Am J Surg Pathol 19: 192–206
Persing DH, Rakela J (1992) Polymerase chain reaction for detection of hepatitis viruses: panacea or purgatory? Gastroenterology 103: 1098–1099
Pouterucha JJ, Rakela J, Lumeng L, Lee C-H, Taswell HF, Wiesner RH (1992) Diagnosis of chronic hepatitis C after liver transplantation by detection of viral sequences by polymerase chain reaction. Hepatology 15: 42–45
Sampietro M, Salvadori S, Badalamenti S, Graziani G, Fiorelli G (1995) Single tube reverse transcription and hemi- nested polymerase chain reaction of hepatitis C virus RNA to detect viremia in serologically negative hemodialyzed patients. Int J Clin Lab Res 25: 52–54
Samuel D, Muller R, Alexander G, Fassati LR, Ducot B, Benhamou J-P, Bismuth H and the investigators of the European Concerted Action on Viral Hepatitis Study (1993) Liver transplantation in European patients with the hepatitis B surface antigen. N Engl J Med 329: 1842–1847
Shiffman ML, Contos MJ, Luketic VA, Santal AJ, Purdum PP, Mills AS, Fisher RA, Posner MP (1994) Biochemical and histologic evaluation of recurrent hepatitis C following orthotopic liver transplantation. Transplantation 57: 526–532
Simmonds P (1995) Variability of hepatitis C virus. Hepatology 21: 570–583
Vargas V, Comas P, Castella LI, Quer J, Esteban JI, Allende E, Esteban R, Guardia J, Margarit C (1994) Incidence and outcome of hepatitis C virus infection after liver transplantation. Transplant Int 7 (suppl 1): S216 - S220
Wright TL, Donegan E, Hsu HH, Ferrel L, Lake JR, Kim M, Combs C, Fennessy S, Roberts JP, Ascher NL, Greenberg HB (1992) Recurrent and acquired hepatitis C viral infection in liver transplant recipients. Gastroenterology 103: 317–322
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© 1996 Springer-Verlag Berlin Heidelberg
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Caccamo, L. et al. (1996). Hepatitis C virus Genotypes and reinfection of the graft during long-term follow-up in 35 liver transplant recipients. In: Mühlbacher, F., et al. Transplant International . Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-00818-8_52
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DOI: https://doi.org/10.1007/978-3-662-00818-8_52
Publisher Name: Springer, Berlin, Heidelberg
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