PROPHYLACTIC ALPHA-INTERFERON THERAPY FOLLOWING LIVER-TRANSPLANTATION- DOES IT PREVENT ALLOGRAFT INFECTION

Objective: To assess the efficacy and safety of prophylactic alpha-int erferon therapy in liver allograft recipients. Patients: An open-label consecutive series of liver transplant recipients who underwent surge ry for chronic hepatitis B virus (HBV) and C virus (HCV) disease. Inte rventions: Alpha-interferon, 5 MU three times weekly, was administered to 16 liver allograft recipients, beginning 3 weeks after transplanta tion for a total of 6 months or more. Main outcome measures: Clearance of hepatitis B surface antigen (HBsAg) or HCV-RNA from blood, liver h istology and standard measures of liver biochemistry. Results: Of the patients with HBV-related disease, seven out of eight remained HBsAg-n egative despite discontinuing anti-HBV hyperimmune gammaglobulin thera py. None of the patients with HCV disease became HCV-RNA-negative. All experienced progression in their hepatitis activity index (Knodell) s core. Only two episodes of liver allograft rejection were observed, bo th of which were easily treated with additional immunosuppression. Con clusions: Prophylactic interferon therapy can be administered to liver allograft recipients for the prevention of recurrent HBV infection. A t a dose of 5 MU three times weekly, alpha-interferon enhanced HBsAg c learance, but failed to clear HCV-RNA.