In this study, researchers from Australia and Japan evaluated the influence of hepatitis C virus (HCV) genotype and rejection episodes on orthotopic liver transplantation (OLT). They also determined the influence of these factors on hepatitis recurrence, and progression to graft cirrhosis after OLT.
The research team included 53 patients who had undergone OLT for end-stage liver cirrhosis. They determined the hepatitis C genotype for each patient.
They diagnosed recurrent hepatitis and rejection using liver function tests and a liver biopsy.
|32% of patients were infected with HCV genotype 1b.|
The patients were followed up for a mean of 51.9 months.
The researchers found that the cumulative survival rate in patients with OLT for hepatitis C was no different to that for all other liver diseases.
The team detected serum HCV RNA in 93% of patients after OLT, and histological recurrence in 85%.
They found that 1-, 3-, and 5-year recurrence rates were 48%, 77%, and 85%, respectively.
Of the 41 patients with recurrent hepatitis C, the researchers found that 10% had cirrhosis, 44% hepatitis with fibrosis, and 46% hepatitis without fibrosis.
In addition, the team found that 32% of patients were infected with HCV genotype 1b, and 68% with other HCV genotypes.
The team determined that recurrence rates were significantly higher in patients infected with genotype 1b than in those with other genotypes.
Overall, 42% patients experienced acute rejection. The researchers identified a strong association between the number of rejection episodes and incidence of HCV-related cirrhosis.
Dr Hiroyuki Sugo’s team concluded, “Our findings showed the genotype 1b to result in a higher recurrence rate after OLT”.
“On the other hand, rejection episodes were associated with a more rapid progression to graft cirrhosis”.