HEPATITIS TYPE-C AFTER ORTOTHOPIC LIVER-TRANSPLANTATION - REINFECTIONAND DISEASE RECURRENCE

We determined the prevalence of hepatitis C virus markers and the clin ical course in patients transplanted for terminal type C or non-A, non -B cirrhosis. Hepatitis C virus infection recurred in 16 of 17 patient s (94%) with type C cirrhosis (seropositive for hepatitis C virus prio r to surgery) and in 10 of 11 patients (91%) with non-A, non-B cirrhos is whose hepatitis C virus status prior to surgery had not been determ ined. Markers of hepatitis C virus were detected in 4 of 16 liver tran splants whose donors tested negative for hepatitis C virus prior to su rgery; this figure represents the risk of hepatitis C virus acquisitio n from external sources at or after transplantation. In 18 of 26 reinf ected patients aminotransferases increased after grafting and remained elevated throughout the 14 to 79 (mean 46.5) months of follow up. The histological findings varied from mild or moderate hepatitis in 15 pa tients to severe active hepatitis in two patients. Two patients develo ped cirrhosis; one of them died of intercurrent infection while she wa s receiving immunosuppressive therapy for chronic rejection. Patients transplanted for hepatitis C virus or non-A, non-B liver disease are a t high risk of hepatitis C virus reinfection. However the course of re current hepatitis C is most often mild and compatible with a normal li fe and an excellent survival rate. (C) Journal of Hepatology.