In two studies recently published in The American Journal of Gastroenterology, researchers have tried to elucidate the factors responsible for a common phenomenon: the recurrence of hepatitis C after liver transplantation.
One of the studies (1997;92:1458-1462), conducted by Javier Crespo, MD, and colleagues at University Hospital "Marqués de Valdecilla" in Santander, Spain, evaluated the histological and virological outcome in 25 patients who underwent orthotopic liver transplantation (OLT) for cirrhosis related to hepatitis C. They concluded that the recurrence "is related to higher levels of viremia and the presence of anti-HCV core IgM, but not to the HCV genotype. However, disease severity is not related to viremia levels, HCV genotype, or positivity of anti-HCV core IgM."
In the second study (1997;92:1453-1457), Hugo R. Rosen, MD, and colleagues at The Dumont-UCLA Transplant Center in Los Angeles retrospectively analyzed the consequences of using the immunosuppressant OKT3 for steroid-resistant rejection (SRR) of liver transplantation. Their results showed that treatment of SRR with OKT3 "may jeopardize long-term allograft function and survival in HCV-infected recipients by enhancing viral hepatitis recurrence. Clearly, the recognition of recurrent HCV and differentiation from acute cellular rejection remains a crucial issue in managing the OLT recipient with HCV."
In an editorial (1997:92;1416-1417), Michael F. Sorrell, MD, of the University of Nebraska in Omaha writes that the findings stress the need for "antiviral agents targeted against HCV that are safe and effective in both the native and transplanted liver." Without an alternative to transplantation, he says that the demand on the already limited donor organ supply could become staggering given that about 1.5% of the population of the United States is infected with HCV, more than 70% of the infections will result in some form of chronic hepatitis, and 20% of that group will develop cirrhosis.
Please be aware that medical advice, diagnoses and physician references cannot be obtained from this site.