Accelerated hepatitis C virus kinetics but similar survival rates in recipients of liver grafts from living versus deceased donors

This study tested the hypothesis that hepatitis C virus (HCV) RNA and core antigen levels rise more rapidly after liver transplantation (LT) in recipients of grafts from living donors (LD) versus deceased donors (DD). Eleven consecutive LD and 15 DD recipients were followed prospectively. Before LT, median HCV RNA levels were similar: 5.42 (LDLT) and 5.07 (DDLT) log10 IU/mL (P = NS). During the first 7 hours after LT a trend toward a greater HCV RNA decrease in LDLT patients was seen, although they received fewer blood replacement products during surgery. HCV RNA levels rose more rapidly in LDLT patients between days 1 and 3 (P = .0059) and were higher in this group on days 2, 3, 4, and 5. Core antigen levels were significantly higher in LDLT patients on days 3 and 5, although they were similar before LT (P = NS). Alanine aminotransferase (ALT) values were higher among LDLT patients from 8 to 14 days and from 4 to 24 months. Two‐year graft and patient survival were 73% for LDLT patients and 80% for DDLT patients (P = NS). In conclusion, viral load rose more rapidly in LD recipients and reached higher levels shortly after surgery. Greater ALT elevations were evident in the LDLT group, but survival rates were similar. The trend toward a greater initial viral load decrease in patients with LD grafts and the significantly sharper increase suggest that the liver plays a predominant role in both HCV clearance and replication. (HEPATOLOGY 2005;42:1420–1428.)

[1]  P. Pontisso,et al.  Profiles of HCV core protein and viremia in chronic Hepatitis C: possible protective role of core antigen in liver damage , 2005, Journal of medical virology.

[2]  N. Heaton,et al.  The ‘small for size’ liver syndrome , 2005, Current opinion in critical care.

[3]  M. Berenguer.  What determines the natural history of recurrent hepatitis C after liver transplantation? , 2005, Journal of hepatology.

[4]  Harel Dahari,et al.  Second hepatitis C replication compartment indicated by viral dynamics during liver transplantation. , 2005, Journal of hepatology.

[5]  R. Fisher.  On comparing adult living donor liver transplantation to adult deceased donor liver transplantation: What have we learned? , 2004, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[6]  K. Koh,et al.  Factors affecting graft survival after living donor liver transplantation. , 2004, Transplantation proceedings.

[7]  H. Yoo,et al.  Graft and patient survival after adult live donor liver transplantation compared to a matched cohort who received a deceased donor transplantation , 2004, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[8]  R. Fisher,et al.  Histologic recurrence of chronic hepatitis C virus in patients after living donor and deceased donor liver transplantation , 2004, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[9]  M. Russo,et al.  Is severe recurrent hepatitis C more common after adult living donor liver transplantation? , 2004, Hepatology.

[10]  J. Llovet,et al.  Hepatitis C recurrence is more severe after living donor compared to cadaveric liver transplantation , 2004, Hepatology.

[11]  K. Reddy,et al.  Allograft Survival Following Adult‐to‐Adult Living Donor Liver Transplantation , 2004, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[12]  W. Gerlich,et al.  Variable Ratio of Hepatitis C Virus RNA to Viral Core Antigen in Patient Sera , 2004, Journal of Clinical Microbiology.

[13]  M. Zand,et al.  IMPACT OF HEPATITIS C VIRAL INFECTION IN PRIMARY CADAVERIC LIVER ALLOGRAFT VERSUS PRIMARY LIVING-DONOR ALLOGRAFT IN 100 CONSECUTIVE LIVER TRANSPLANT RECIPIENTS RECEIVING TACROLIMUS , 2004, Transplantation.

[14]  J. Galanko,et al.  Patient and graft survival in hepatitis C recipients after adult living donor liver transplantation in the United States , 2004, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[15]  I. Colle,et al.  Hepatitis C infection-related liver disease: patterns of recurrence and outcome in cadaveric and living-donor liver transplantation in adults , 2004, Transplantation.

[16]  V. Balan,et al.  Hepatitis C Virus Recurrence in Living Donor Liver Transplant Recipients , 2004, Digestive Diseases and Sciences.

[17]  G. Everson,et al.  Role of adult living donor liver transplantation in patients with hepatitis C , 2003, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[18]  J. Emond,et al.  Increased risk of cholestatic hepatitis C in recipients of grafts from living versus cadaveric liver donors , 2003, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[19]  J. Trotter,et al.  Adult‐to‐adult right hepatic lobe living donor liver transplantation , 2002 .

[20]  D. Lu,et al.  Donor and recipient outcomes in right lobe adult living donor liver transplantation , 2002, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[21]  A. Moya,et al.  Contribution of donor age to the recent decrease in patient survival among HCV‐infected liver transplant recipients , 2002, Hepatology.

[22]  X. Forns,et al.  Hepatitis C virus kinetics during and immediately after liver transplantation , 2002, Hepatology.

[23]  Nancy M. Stolpman,et al.  Living donor liver transplant recipients achieve relatively higher immunosuppressant blood levels than cadaveric recipients , 2002, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[24]  R. Oren.  Hepatocyte proliferation – can we target the mechanism? , 2002 .

[25]  Charles M. Miller,et al.  Living donor liver transplantation: Summary of a conference at The National Institutes of Health , 2002, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[26]  P. Bioulac-Sage,et al.  Timing of reinfection and mechanisms of hepatocellular damage in transplanted hepatitis C virus–reinfected liver , 2002, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[27]  P. Hayashi,et al.  Review article: adult-to-adult right hepatic lobe living donor liver transplantation. , 2002, Alimentary pharmacology & therapeutics.

[28]  R. Bartenschlager,et al.  Characterization of Cell Lines Carrying Self-Replicating Hepatitis C Virus RNAs , 2001, Journal of Virology.

[29]  K. Batts,et al.  Early identification of recipients with progressive histologic recurrence of hepatitis C after liver transplantation , 2000, Hepatology.

[30]  R. Fisher,et al.  Liver regeneration and function in donor and recipient after right lobe adult to adult living donor liver transplantation. , 2000, Transplantation.

[31]  T. Crabtree,et al.  Prediction of liver allograft fibrosis after transplantation for hepatitis C virus: Persistent elevation of serum transaminase levels versus necroinflammatory activity , 2000, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[32]  M. Honda,et al.  Cell cycle regulation of hepatitis C virus internal ribosomal entry site-directed translation. , 2000, Gastroenterology.

[33]  Randall G. Lee,et al.  Banff schema for grading liver allograft rejection: An international consensus document , 1997, Hepatology.

[34]  S. Fan,et al.  Minimum graft volume for successful adult-to-adult living donor liver transplantation for fulminant hepatic failure. , 1996, Transplantation.

[35]  A. Gown,et al.  Persistent hepatitis C virus infection after liver transplantation: Clinical and virological features , 1995, Hepatology.

[36]  S. A. Kucharski.  Fulminant hepatic failure. , 1993, Critical care nursing clinics of North America.

[37]  P. Scheuer,et al.  Classification of chronic viral hepatitis: a need for reassessment. , 1991, Journal of hepatology.

[38]  G. Beeson,et al.  in adults with , 2019 .