Patients with cryptogenic cirrhosis (CC) make up a significant proportion of liver transplant recipients.
However, poor outcome following transplantation has been reported by some centers. It has been found that fibrosis occurs in a significant number of patients.
In this study, researchers from England compared patients who underwent liver transplantation for CC with recipients who underwent transplantation for hepatitis C virus (HCV) and alcohol-related cirrhosis (AC).
They assessed 46 patients with CC, 58 with HCV, and 53 with AC. All patients underwent transplantation between 1989 and 1999.
During the course of the study, CC patients were followed-up for a mean of 46 months, AC patients for 41 months, and HCV for 49 months.
The team did not obtain any protocol liver biopsy specimens. Biopsies were performed only to investigate biochemical abnormalities.
|Acute cellular rejection occurred in 30% of patients.|
The physicians found that acute cellular rejection occurred in 30% of CC, 26% of AC, and 37% of HCV patients.
They also determined that overall patient and graft survival at 1 year was 85% and 80% for CC patients. This was not significantly different from 87% and 81% for AC patients, and 91% and 82% for patients with HCV.
In addition, 5-year patient and graft survival was 81% and 77% for CC, 60% and 48% for AC, and 79% and 57% for HCV patients.
The team did not find histological evidence of cirrhosis in any patient who underwent transplantation for CC. However, this was found in 2% of patients who underwent transplantation for AC and 16% of patients who underwent transplantation for HCV.
Dr Michael Heneghan's team concluded, "These results suggest that CC is a favorable indication for OLT and that although a proportion of patients develop inflammation in the liver allograft, this does not result in significant graft dysfunction or loss".