[Frequency and severity of viral hepatitis C after liver transplantation. Study in 28 patients]

Abstract

Objectives and methods: HCV cirrhosis is one of the major indications for liver transplantation. HCV recurrence rate is high but long term development to cirrhosis seems to be rare. This study included 28 patients with HCV infection (HCV RNA in blood, histologic lesions highly suggestive or compatible with HCV infection).

Results: Twenty-one out of the 28 patients were transplanted for hepatic chronic liver disease associated with HCV infection (reinfection), whereas only 7 out of 94 transplanted patients (7.4%) without pre-transplant HCV infection ("de novo" infection). Patients were followed clinically and histologically for a mean period of 26.8 months (range: 3-56). Of 26 patients with a good histological evaluation, 24 (92.3%) had chronic hepatitis: 7 with mild activity, 17 with moderate activity, 7 of whom had bridging fibrosis. Two patients had unusual features with associated lesions (necrotic hepatitis and chronic rejection in one case, acute hepatitis associated with CMV infection in the other).

Conclusion: This study confirms the high prevalence of HCV recurrence, as well as the "de novo" infection risk, and suggests caution concerning long term prognosis.