We have investigated hepatitis C virus (HCV) viremia before and after orthotopic liver transplantation (OLT). 38 patients were examined; 16 were anti-HCV positive and 22 anti-HCV negative pre-OLT in a RIBA-2 test (Ortho Diagnostic Systems Inc., Westwood, MA). HCV-RNA was detected using a modified nested polymerase chain reaction in 14/38 and 10/38 patients before and after OLT, respectively. 7 of these 14 subjects who were HCV-RNA positive before OLT were also positive for serum hepatitis B surface antigen. After
Liver transplantation for liver diseases related to hepatitis B virus (HBV) and hepatitis delta virus (HDV) remains problematic because of the risk of viral recurrence. We report here the long-term virological outcome of patients transplanted for HDV-related liver cirrhosis (HDV cirrhosis). From December 1984 to December 1990, 76 patients with HDV cirrhosis underwent liver transplantation. Before transplantation, all the patients were HBsAg-positive/anti-HDV positive, and all but one were HBV DNA-negative by dot blot hybridization. HDV RNA was detected by HDV RT-PCR and liver HDAg by fluorescent HDV Ab. After transplantation, all the patients except four received continuous long-term anti-HBs passive immunoprophylaxis. The actuarial 5-year survival was 88%. All patients who did not receive anti-HBs immunoprophylaxis remained HBsAg-positive and developed hepatitis. Among the 68 patients receiving antiHBs immunoprophylaxis with a minimum follow-up of 2 months, HBsAg reappeared in 7 (10.3%) after a mean of 17 months. These seven patients developed hepatitis, with simultaneous HBV and HDV replication; and four cleared later HBsAg. Patients without HBV reinfection were studied for HDV reinfection: liver HD Ag or serum HDV RNA were present in 88% of the patients during the first year, without developing hepatitis; however, they were no longer detectable after 2 years in 95% of the patients. In conclusion, liver transplantation for HDV cirrhosis gives good results, with a 5-year actuarial survival of 88%.(ABSTRACT TRUNCATED AT 250 WORDS)
lower, whereas the incidence of septic complications A retrospective analysis was undertaken to determine was comparable with that in the other groups. The inciif the incidence, timing, and severity of acute and dence of acute rejection in patients who have undergone chronic rejection were influenced by the primary distransplantation for nonviral disease receiving polyease necessitating transplantation. Of the 875 liver clonal human anti-cytomegalovirus (CMV) immunoglobtransplantations performed between 1984 and 1992, 768 ulins was also significantly lower than that of patients were primary transplantations and 107 were retranswho did not receive the immunoglobulins (19% vs. 48% plantations. Among the former, 330 patients that were at 3 months; P Å .01), and this was identical to that of liver transplant recipients for a chronic liver disease patients who have undergone transplantation for viral without cancer in the native liver received an ABO-comdisease receiving polyclonal human anti-HBs immunopatible and cross-match-negative graft and were given a cyclosporine-or tacrolimus-based immunosuppres-globulins (19% at 3 months). These results show that the sion. These included primary biliary cirrhosis (PBC, 66 risk of rejection is unequal among patients, being lower patients), primary sclerosing cholangitis ( or monoclonal antibodies in the early postoperative pe-
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