End-stage liver disease associated with HCV
infection has become one of the leading indications for
liver transplantation and it is the most common disease recurring after
liver transplantation. The aim of this retrospective study was to asses factors potentially affecting outcome in patients transplanted for HCV-related
liver disease. Among 164 adult patients who underwent orthotopic
liver transplantation from December 1994 to December 2002, 134 survived >2 months, including 25 with HCV-related
liver disease. Mean follow-up after LTx was 24.8 months (range, 2.1-99.4). Anti-HCV was negative in all donors. The parameters considered in our analysis were: the course, outcome, and liver function tests at 1-year follow-up after HCV
reinfection: the potential impact of maintenance and induction immunosuppressive regimens; and episodes of acute rejection. Deterioration of graft function because of HCV
reinfection occurred in 16 patients (64%). Mean time for deterioration of liver function related to
reinfection was 4.5 months (range, 0.83-23). Induction and maintenance immunosuppression did not affect outcome of HCV-infected
liver transplant recipients.
Aminotransferases were significantly higher among HCV-infected recipients than among the other patients in our series. There was a slight tendency for earlier recurrence of HCV
hepatitis among patients treated with high-dose
steroids because of acute rejection.