The team examined the histological recurrence and progression of hepatitis C after orthotopic liver transplantation (OLT).
The findings of the study were reported in the December issue of Liver Transplantation.
A blinded retrospective review of clinical, serological, and histopathologic features of 65 patients who underwent OLT for hepatitis C was conducted.
Histological findings of recurrent hepatitis C and progression (fibrosis, ≥ grade 2 by last follow-up) were correlated with clinical parameters.
The researchers found that histological recurrence of hepatitis C was present in 43 of 65 patients, with progression in 19 patients.
|Hepatitis C recurrence and progression:|
With azathioprine: 35% and 6%
Without azathioprine: 77% and 38%
| Liver Transplantation |
Histological findings in the native liver and post-OLT biopsy specimen at the time of recurrence showed no correlation with hepatitis C recurrence and progression.
Patients treated with azathioprine-containing immunosuppressive regimens experienced less recurrence than those without azathioprine as part of their immunosuppressive regimen (6 of 17 (35%) versus 37 of 48 (77%) patients). They also experienced less progression (1 of 17 (6%) versus 18 of 48 (38%) patients).
No difference was seen between patients treated with cyclosporine versus those administered FK506.
Histological recurrence of hepatitis C after OLT is seen in 66% of patients with progressive disease, and 29% of all patients.
John Hunt, of the Beth Israel Deaconess Medical Center, Boston, said on behalf of his colleagues, "The grade of inflammation in the native liver at the time of OLT and time of recurrence is not predictive of progression."
"Azathioprine-containing regimens reduce histological recurrence and progression of hepatitis C in post-OLT patients," he concluded.