Chronic rejection associated with antiviral therapy for recurrent hepatitis C after living-donor liver transplantation.

Abstract

BACKGROUND:

Chronic rejection (CR) has been reported to be associated with antiviral therapy for recurrent hepatitis C in liver transplant (LT) recipients. The aims of this study were to clarify the details of antiviral therapy-associated CR after living-donor liver transplantation (LDLT) and to identify the factors associated with CR.

METHODS:

A retrospective chart review was performed on 125 recipients who had received antiviral therapy for recurrent hepatitis C after LDLT between January 2001 and September 2012. The characteristics of patients who developed CR during or within 6 months after antiviral therapy were compared with those of 76 patients who did not develop CR despite receiving antiviral therapy for more than 1 year.

RESULTS:

Seven of 125 (6%) patients developed CR during or within 6 months after the end of antiviral therapy. CR was diagnosed after a median (range) of 9 (1-16) months of antiviral therapy. In five patients, rejection progressed rapidly and resulted in death within 3 months after diagnosis. Analysis revealed two significant factors associated with CR: reduction of the immunosuppressant dose during antiviral therapy and a low fibrosis score as the indication for antiviral therapy.

CONCLUSIONS:

CR developed in association with antiviral therapy for recurrent hepatitis C after LDLT. This complication may be prevented by ensuring that the immunosuppressant dose is not reduced during antiviral therapy.

• Authors: Yoshihide Ueda, Toshimi Kaido, Takashi Ito, Kohei Ogawa, Atsushi Yoshizawa, Yasuhiro Fujimoto, Akira Mori, Aya Miyagawa-Hayashino, Hironori Haga, Hiroyuki Marusawa, Tsutomu Chiba, Shinji Uemoto
• Journal: Transplantation (Transplantation) Vol. 97 Issue 3 Pg. 344-50 (Feb 15 2014) ISSN: 1534-6080 [Electronic] United States
• PMID: 24157473 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antiviral Agents
• Immunosuppressive Agents
• Interferon-alpha
• Recombinant Proteins
• Polyethylene Glycols
• Ribavirin
• Interferons
• peginterferon alfa-2a

Topics

• Adult
• Aged
• Antiviral Agents (adverse effects, therapeutic use)
• Female
• Fibrosis
• Graft Rejection (chemically induced)
• Hepatitis C (drug therapy, therapy)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Interferon-alpha (administration & dosage)
• Interferons (administration & dosage)
• Liver Failure (mortality, therapy, virology)
• Liver Transplantation (methods)
• Living Donors
• Male
• Middle Aged
• Polyethylene Glycols (administration & dosage)
• Recombinant Proteins (administration & dosage)
• Recurrence
• Retrospective Studies
• Ribavirin (administration & dosage)
• Risk Factors
• Time Factors
• Treatment Outcome