Numerous factors for aggressive Hepatitis C virus recurrence after liver transplantation have been recognized.
Despite this recognition, the understanding of this phenomenon is incomplete.
Dr John O'Grady and colleagues from England tested the hypothesis that diabetes mellitus was implicated in this phenomenon.
The investigative team evaluated 163 patients undergoing primary liver transplantation for Hepatitis C virus from 1990 to 2004.
The team scored biopsies according to the modified Ishak score.
Severe recurrence of Hepatitis C virus was defined as a fibrosis score of 4 within 6 years of liver transplantation.
The team assessed risk factors that included recipient, donor and transplant variables.
|Fibrosis risk increases 8-fold with a liver received from an older donor, and having diabetes|
|American Journal of Transplantation|
The investigators found that 33% of patients had a fibrosis score of 4 at the end of the study period.
Factors associated with progression to severe fibrosis was donor age, especially donor age above 55 years.
The team observed that pre-liver transplantation diabetes mellitus, and diabetes mellitus post-liver transplantation were also associated with severe fibrosis.
The combination of receiving a liver from a donor older than 55 years and having diabetes mellitus post-liver transplant gave an 8-fold risk of severe fibrosis.
Dr O'Grady's team concluded, “These data indicate that diabetic status is one of the more important variables determining the severity of Hepatitis C virus recurrence and is synergistic with donor age.”
“This observation may provide an additional management opportunity to modify the impact of Hepatitis C virus recurrence.”