Hepatic Preservation Injury: Severity of Hepatitis C Recurrence and Survival After Liver Transplantation

Abstract

Background Preservation injury in the HCV liver transplant population has been reported to correlate with poorer survival outcomes compared to preservation injury in the non-HCV liver transplant population. However, determinants of progression to cirrhosis in HCV infection remain poorly defined in this population. Aim This study aimed to determine if presence and severity of preservation injury impact the acceleration of HCV recurrence and survival after liver transplant. Methods We retrospectively reviewed liver transplant HCV patients over a 10-year period. Biopsies from POD 7 were assessed for preservation injury and 4 and 12-month biopsies were assessed for fibrosis. Patients with Ishak fibrosis > 0.8 units/year were considered rapid fibrosers. Results Our study group consisted of 255 patients. The mean age was 49.3 years old, 180 (70.6%) were male and 221 (86.7%) were Caucasian. The incidence of preservation injury on the 7-day biopsy was 69.0%. A strong correlation between postoperative peak AST within the first week and preservation injury was found. The overall prevalence of rapid fibrosers at 4-months, 1-year and 2-years was 47.4%, 75.2%, and 58.9%, respectively. The prevalence of rapid fibrosers at 4 months, 1 and 2 years between patients with or without preservation injury was not statistically significant (p=0.39, p=0.46, and p=0.53, respectively). No differences were seen between patients with and without PI in terms of patient and graft survival. Conclusion In this study, the presence and severity of preservation injury were not associated with development of rapid HCV recurrence or worsening in survival.