Dr Luca Saverio Belli and colleagues from Italy report further findings from previous observations made in recurrent Hepatitis C.
The researchers had observed that various immunological factors are associated with the occurrence of histologically proven recurrent Hepatitis C.
The 2 specific issues investigated were to confirm the associations of MHC alleles and donor/recipient mismatch with the occurrence of recurrent Hepatitis C.
The research team assessed 2 separate independent cohorts of newly transplanted patients.
A look-back cohort of 120 patients and a cohort for studying the disease progression of 190 patients were included.
The team evaluated immunologic and nonimmunologic variables affecting the severity of the recurrent disease.
|HLA-DRB1 donor-recipient mismatch was an independent risk factor for severe fibrosis|
Protocol liver biopsies were obtained at least 1, 3, 5, 7, and 10 years after liver transplantation.
A fully mismatched donor/recipient pair at the DRB1 locus was associated with the recurrence of histologic Hepatitis in the look-back cohort.
The researchers found that the mismatched donor/recipient pair at the CDRB1 locus was also associated with a progression beyond stage 3 in the second cohort.
Relevant immunologic and nonimmunologic variables were included into a multivariate Cox proportional model.
The team noted that donor age, full HLA-DRB1 donor-recipient mismatch, and HLA B14, were independent risk factors for the development of severe fibrosis.
Dr Belli's team concludes, “This study provides evidence that DRB1 donor-recipient mismatch affects both the occurrence and progression of recurrent Hepatitis C disease.”
“This information is clinically relevant as it may help to better allocate organs and to recognize patients at risk for progression so that specific interventions can be implemented.”