Liver transplantation for hepatitis B and C virus-related cirrhosis: mid-term results

Transplant Proc. 2010 May;42(4):1200-3. doi: 10.1016/j.transproceed.2010.03.111.

Abstract

Hepatitis C virus (HCV) recurrence after orthotopic liver transplantation (OLT) is almost universal; cirrhosis develops in up to 30% of cases. Currently there is interest in the midterm outcomes of HCV patients with concomitant hepatitis B virus (HBV) infection among OLT recipients. We therefore retrospectively analyzed our database of patients who underwent OLT for HCV-HBV-related cirrhosis. Between April 1992 and December 2008, 350 patients underwent OLT, including 20 (5.7%) transplanted for HBV-HCV cirrhosis. We assessed patient and graft survivals at 1 and 5 years, as well as the progression of fibrosis. Protocol liver biopsies were available yearly after OLT. The survival curves were analyzed by the Kaplan-Meier approach and chronic hepatitis evaluated according to the Ishak scoring system. At a median follow-up of 68.4 +/- 53 months, the 1- and 5-year patient and graft survival rates were 80% and 70%, respectively. The 5-year fibrosis progression rate was 0.17 +/- 0.08 units of fibrosis. The only patient who developed histologic cirrhosis within 10 years of follow-up showed a lamivudine-resistant HBV recurrence. Patients transplanted for HBV-HCV coinfection showed a lower fibrosis progression rate compared with HCV monoinfected subjects.

MeSH terms

  • Azathioprine / therapeutic use
  • Cyclosporine / therapeutic use
  • Graft Survival
  • Hepatitis B / immunology
  • Hepatitis B / surgery*
  • Hepatitis C / immunology
  • Hepatitis C / surgery*
  • Humans
  • Immunoglobulins / therapeutic use
  • Immunosuppressive Agents / therapeutic use
  • Liver Transplantation / immunology
  • Liver Transplantation / mortality
  • Liver Transplantation / physiology*
  • Prednisone / therapeutic use
  • Retrospective Studies
  • Survival Rate
  • Tacrolimus / therapeutic use
  • Treatment Outcome

Substances

  • Immunoglobulins
  • Immunosuppressive Agents
  • Cyclosporine
  • Azathioprine
  • Prednisone
  • Tacrolimus
  • hepatitis B hyperimmune globulin