Risk factors in patients with rapid recurrent hepatitis C virus-related cirrhosis within 1 year after liver transplantation.

Abstract

BACKGROUND:

Recurrent cirrhosis (RC) due to pretransplant underlying disease leads to organ failure and subsequent death after orthotopic liver transplantation (OLT). RC occurs in up to 30% of patients with recurrent hepatitis C (HCV) within 5 years after OLT. We sought to identify early risk factors for rapid RC within the first year after OLT in HCV-positive patients.

METHODS:

Among 404 liver transplanted patients at the University of Mainz between 1998 and 2008, 90 were HCV-RNA positive. To identify predictive factors for rapid RC, we compared HCV-positive patients with advanced fibrosis stages within 1 year after OLT (n = 13) with these without RC at 5 years after OLT (n = 23).

RESULTS:

Overall, poorer patient survival was associated with advanced fibrosis scores in the 1-year protocol biopsy and nonresponse to interferon treatment before OLT. The strongest predictive factors for rapid RC were persistently high levels of alkaline phosphatase, bilirubin, viral load at 6 months after OLT, and multiple steroid pulse therapies. The CCR2-V64I polymorphism was not associated with rapid RC.

CONCLUSION:

We presented a group of patients with HCV-related rapid RC within the first year after OLT to identify predictive factors for rapid fibrosis progression.

• Authors: T Zimmermann, C Otto, M Hoppe-Lotichius, S Biesterfeld, A Lautem, M Knaak, A Zimmermann, A P Barreiros, M Heise, J M Schattenberg, M F Sprinzl, P R Galle, G Otto, M Schuchmann
• Journal: Transplantation proceedings (Transplant Proc) 2009 Jul-Aug Vol. 41 Issue 6 Pg. 2549-56 ISSN: 1873-2623 [Electronic] United States
• PMID: 19715972 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Carcinoma, Hepatocellular (surgery)
• Female
• Follow-Up Studies
• Hepatitis C (epidemiology, surgery)
• Humans
• Liver Cirrhosis (epidemiology, virology)
• Liver Neoplasms (surgery)
• Liver Transplantation (mortality, statistics & numerical data)
• Male
• Middle Aged
• Predictive Value of Tests
• Recurrence
• Retrospective Studies
• Risk Factors
• Survival Rate
• Survivors
• Time Factors
• Viral Load