Hepatitis C virus (HCV) infection may have a more aggressive course following living donor liver transplantation compared to cadaveric liver transplantation.
In this study, doctors from Spain examined whether HCV disease recurrence differs between living donor liver transplantation and cadaveric liver transplantation.
The team evaluated 116 consecutive HCV-infected patients undergoing 117 liver transplantations in a single center from March 2000 to August 2003.
They defined severe recurrence as biopsy-proven cirrhosis and/or the occurrence of clinical decompensation.
Median follow-up was 22 months.
The team found that 22% of patients had severe recurrence of hepatitis C.
|22% of patients had severe recurrence of hepatitis C.|
Severe recurrence developed in 18% of patients in the cadaveric liver transplantation group and in 41% of patients in the living donor liver transplantation group.
The doctors calculated that the 2-year probability of severe recurrence was significantly higher in living donor liver transplantation compared to cadaveric liver transplantation.
Using univariate analysis, the team found that living donor liver transplantation and an ALT higher than 80 IU/L 3 months after transplantation were predictors of severe recurrence.
Using results from a subset of patients, they established that a lobular necroinflammatory score >1, living donor liver transplantation, and biliary complications were associated with severe recurrence.
However, the only variables which were independently associated with severe recurrence were living donor liver transplantation and a lobular necroinflammatory score >1.
Dr Montserrat Garcia-Retortillo and colleagues concluded, "HCV recurrence is more severe in living donor liver transplantation compared to cadaveric liver transplantation".
"Although our results were based on a single-center experience, they should be considered in the decision-making process of transplant programs, since severe HCV recurrence may ultimately compromise graft and patient survival."