Document Detail


Liver transplantation for HCV cirrhosis; cautious optimism after 10 years of experience.
MedLine Citation:
PMID:  23274318     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Currently, HCV (hepatitis C virus) cirrhosis is one of the most common indications for liver transplantation (LTx) in Europe and North America among adults. Very early after LTx, histological examinations of liver biopsies in a group of HCV-positive recipients show important differences compared to other indications for transplantation.
MATERIAL/METHODS: We described results of 121 primary LTx for HCV cirrhosis. HCV-RNA PCR was positive in 94% of primary graft recipients prior to LTx. Co-existing HCC was diagnosed in 20.66% of recipients.
RESULTS: One-year, 5-year, and 10-year survivals in the HCV-positive recipient group were 87.6%, 85.9%, and 84.3%, respectively. Symptomatic recurrent hepatitis was diagnosed in 58/121 (47.54%) recipients, and 41.3% presented with recurrence within the first 6 months. None of the PCR-negative recipients developed recurrent hepatitis prior to LTx. The rescue therapy for recurrent HCV hepatitis consist of Interferon and Ribavirin; the sustained virologic response (SVR) was obtained in 50% and 41% of recipients at 24 and 48 weeks, respectively, after treatment cessation.
CONCLUSIONS: Despite almost universal recurrence of HCV after LTx, results of transplantation are relatively good. Modification of immunosuppression, younger organ selection, and avoiding steroid pulses for rejection improve the results. Inclusion of combination therapy with interferon and Ribavirin allows for more than 40% SVR.
Authors:
Marek Pacholczyk; Beata Łągiewska; Wojciech Lisik; Olga Tronina; Dariusz Wasiak; Tomasz Cieciura; Andrzej Chmura
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Annals of transplantation : quarterly of the Polish Transplantation Society     Volume:  17     ISSN:  2329-0358     ISO Abbreviation:  Ann. Transplant.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-31     Completed Date:  2013-05-28     Revised Date:  2013-06-17    
Medline Journal Info:
Nlm Unique ID:  9802544     Medline TA:  Ann Transplant     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  5-10     Citation Subset:  IM    
Affiliation:
Department of General Surgery and Transplantology, Medical University of Warsaw, Warsaw, Poland.
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MeSH Terms
Descriptor/Qualifier:
Adult
Combined Modality Therapy
Drug Therapy, Combination
Female
Follow-Up Studies
Hepatitis C, Chronic / complications*,  drug therapy,  mortality
Humans
Interferons / therapeutic use
Kaplan-Meier Estimate
Liver Cirrhosis / mortality,  surgery*,  virology
Liver Transplantation*
Male
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Recurrence
Reoperation / statistics & numerical data
Ribavirin / therapeutic use
Survival Rate
Treatment Outcome
Chemical
Reg. No./Substance:
36791-04-5/Ribavirin; 9008-11-1/Interferons

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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