Histologic injury caused by recurrent hepatitis C virus (HCV) occurs in up to 90% of HCV-infected patients who receive a cadaveric liver graft.
In comparison, the natural history of HCV after living donor liver transplantation (LDLT) is unclear.
In this study, researchers from the United States performed a retrospective analysis of 68 consecutive HCV-infected adult patients. Of these 45 received cadaveric grafts (CAD) and 23 grafts from living donors.
The team defined recurrence as elevated serum transaminases, positive HCV RNA, and liver biopsy consistent with histologic evidence of HCV.
The research team found that the incidence of HCV recurrence, as well as the time to recurrence, was no different between the CAD and LDLT groups.
They determined that the overall incidence of HCV recurrence - cholestatic hepatitis, grade III to IV inflammation, and/or HCV-induced graft failure – was not different between the groups.
|17% of living donor liver transplantation patients developed cholestatic hepatitis C.|
However, no CAD patients developed cholestatic hepatitis C, compared with 17% of the LDLT patients.
Dr Paul Gaglio's team concluded, "The timing and incidence of HCV recurrence were not different when comparing CAD versus LDLT".
However, "The incidence of cholestatic hepatitis was significantly greater in patients with HCV who underwent LDLT".
In a related editorial in the same publication, Dr Mitchell Shiffman discusses living donor liver transplantation in patients with chronic hepatitis C.
Dr Mitchell concludes that, "The availability of a living donor may be potentially advantageous for the patient with chronic HCV awaiting LDLT".
"However, this potential will only be realized if the LDLT is timed to occur in conjunction with an organized and aggressive approach to HCV treatment".