Hepatitis C virus reinfection in allografts after orthotopic liver transplantation

• Published in: Hepatology (Baltimore, Md.) Md.), 1992-11, Vol.16 (5), p.1137-1143
• Main Authors: König, Volker, Bauditz, Jürgen, Lobeck, Hartmut, Lüsebrink, Rainer, Neuhaus, Peter, Blumhardt, Gerhard, Bechstein, Wolf Otto, Neuhaus, Ruth, Steffen, Rudolf, Hopf, Uwe
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Female; Hepacivirus - genetics; Hepacivirus - immunology; Hepatitis C; Humans; Immunosuppression; Liver - microbiology; Liver - pathology; Liver Cirrhosis - microbiology; Liver Cirrhosis - pathology; Liver Cirrhosis - surgery; Liver Transplantation; Liver, biliary tract, pancreas, portal circulation, spleen; Male; Medical sciences; Middle Aged; Polymerase Chain Reaction; Recurrence; RNA, Viral - analysis; RNA, Viral - blood; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system
• ISSN: 0270-9139; 1527-3350
• DOI: 10.1002/hep.1840160506

From September 1988 to May 1991, 160 orthotopic liver transplantations were performed in our hospital. Twenty‐four patients had end‐stage cirrhosis caused by chronic non‐A, non‐B hepatitis. Antibodies against hepatitis C virus were documented before and after orthotopic liver transplantation in 13 patients. Studies using the polymerase chain reaction demonstrated hepatitis C virus RNA in the serum and liver tissue of 17 patients (10 of whom tested positive for hepatitis C virus antibodies) before orthotopic liver transplantation. Tissue samples taken from liver grafts during the operation were hepatitis C virus RNA negative in every case. Ten of these 17 patients had positive hepatitis C virus RNA findings in serum and liver biopsy specimens within the first month after surgery. One patient died of Mucor sepsis 2 mo after orthotopic liver transplantation. Another patient died of multiorgan failure 3 mo after a retransplantation. Two patients underwent retransplantation for graft rejection at 2 and 3 mo, respectively. One year after orthotopic liver transplantation, hepatitis C virus RNA was demonstrated in allograft biopsy specimens in 13 of 15 patients. Two patients remained hepatitis C virus RNA negative in repeated biopsies up to 12 mo. Mild portal and lobular hepatitis developed within 6 months of orthotopic liver transplantation in four patients and within 1 yr in five additional patients. The data suggest that persistent hepatitis C virus reinfects the allograft in most cases, but the risk of acute organ damage caused by hepatitis C virus reinfection is low. (HEPATOLOGY 1992;16:1137–1143.)