THE INFLUENCE OF HEPATITIS-C VIRUS GENOTYPES ON THE OUTCOME OF LIVER-TRANSPLANTATION

Background: The aim of this study was to report the influence of hepat itis C virus (HCV) genotypes and HLA matches on the outcome of liver t ransplantation, hepatitis recurrence, and progression to cirrhosis aft er transplantation. Methods: HCV genotypes were determined from pretra nsplantation sera and/or liver explant tissues from 202 patients with HCV-related end-stage liver disease, One hundred fifty patients with k nown infecting genotype for whom posttransplantation biopsy specimens were available or who had normal results of liver injury tests constit uted the group analyzed. Patients were followed up for up to 4.5 years , Hepatitis activity index scores at the time of disease recurrence we re used to assess disease activity. Cirrhosis was diagnosed by using h istological evidence. The number of HLA matches with respect to A, B, DR, and DQ loci was determined. Results: The rates of hepatitis recurr ence were 25% and 75% at 1 year and 4 years, respectively; Kaplan-Meie r survival analysis did not reveal significant differences between the infecting genotypes with respect to overall rates of survival or recu rrence of hepatitis, At hepatitis recurrence, hepatitis activity index scores did not differ between the genotype groups, The distribution o f infecting genotypes among the 7 patients who developed cirrhosis is reflective of pretransplantation distribution, Neither HLA site-specif ic nor total matches affected the rates of survival or disease recurre nce, Conclusions: The infecting HCV genotype had no influence on the i ncidence or severity of recurrent hepatitis, rate of survival, or deve lopment of cirrhosis, HLA matching does not influence transplantation outcome for HCV-related disease. Copyright (C) 1998 by the American As sociation for the Study of Liver Diseases.