Diagnosis and treatment of early acute rejection likely affect the course of recurrent hepatitis C virus (HCV) following liver transplantation.
In this study, doctors from San Francisco, California, evaluated a cohort of liver transplantation recipients to re-examine risk factors for early acute rejection.
The team hypothesized that HCV etiology may represent a significant risk factor for early acute rejection.
They retrospectively reviewed the records of 285 adults undergoing primary liver transplantation for cirrhosis between 1999 and 2002.
|Overall incidence of rejection = 41%.|
The doctors found that HCV cirrhosis was the etiology for 51% of all liver transplantation recipients.
They also found that there were 135 episodes of early acute rejection in 117 recipients; an overall incidence of 41%.
Patient groups with HCV and cholestatic/autoimmune disease had the greatest incidence of rejection (49%).
Univariate analysis identified recipient gender, ethnicity, etiology, year, and posttransplant immunosuppression levels were risk factors for early acute rejection.
However, HCV etiology and female gender remained robust risk factors in multivariate analysis.
Interferon-based therapy did not impact the incidence or timing of early acute rejection.
Dr Ryan McTaggart and colleagues concluded, "HCV etiology is strongly associated with early acute rejection ".
"HCV allograft reinfection may create an immunologic environment predisposed to early acute rejection".
"Alternatively, the association of HCV and early acute rejection may result from an increased frequency of allograft biopsy and may be further exacerbated by inability to accurately diagnose early acute rejection in the setting of recurrent HCV".