Serum hepatitis C virus-ribonucleotide acid monitoring after liver transplantation

Nemes, Balázs; Sárváry, Enikő; Kopper, László; Gerlei, Zs.; Patonai, Attila; Perner, F.; Weszelits, V.; Járay, J.; Schaff, Z.

doi:10.1016/j.dld.2004.09.004

Cited by 9 publications

(6 citation statements)

References 13 publications

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“…The prognostic value of the postoperative HCV-RNA titre in recurrent HCV infection following OLT is controversial [1,2,3]. We have reported previously the correlation of the high C-RNA serum level following OLT, the severity of histopathological signs and the poor clinical outcome [4]. This is consistent with other reports [5].…”

Section: Introductionsupporting

confidence: 82%

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Expression pattern of molecular chaperones after liver transplantation in hepatitis C positive recipients. Relation to serum HCV-RNA titers

Nemes

Doros

Holczbauer

et al. 2009

IMAS

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Hepatitis C (HCV) is one of the main causes of liver transplantation (OLT). Previously we have reported that high serum C RNA level correlates with the severity of histopathological signs and poor clinical outcome. The core antigen of virus C is known to interfere with chaperones in the hepatocytes, results in an endoplasmic reticulum (ER) stress. In this study HCV positive liver transplanted patients were evaluated, whether there are correlations among chaperone expression, recurrence and viral titer. Patients were enrolled after surviving the first month following OLT. Sera were collected regularly, and biopsies were taken on demand following OLT. The diagnosis of recurrent HCV was proven by Knodell-Ishak scoring. In this case ribavirin+interferon were initiated, and maintained for one year. All chaperones were upregulated in the transplanted liver graft showing recurrent hepatitis C disease. ATF6, GP96, GRP78, CNX and CLR chaperones were upregulated significantly compared to their levels in normal livers. Except for one chaperone, the level of upregulation did not correlate with the serum's HCV-RNA titre: the only difference between Group1 and 2 (RNA titre above and below 8.78 106 respectively) was that the level of ATF6 was 1.6 times higher in Group1 compared to Group2. The expression of all chaperones was reduced, and some even became downregulated after the interferon treatment. In accordance with the literature our results suggest that hepatitis C might induce apoptosis through ER-stress. Those cells exposed to a high C viral load, had a lower chance to be eliminated.

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Section: Introductionsupporting

confidence: 82%

“…We also evaluated whether the effect of interferon treatment can be detected in the chaperon expression. In order to determine this we have enrolled the same cohort of patients that we had evaluated in our previous study [4].…”

Section: Introductionmentioning

confidence: 99%

Expression pattern of molecular chaperones after liver transplantation in hepatitis C positive recipients. Relation to serum HCV-RNA titers

Nemes

Doros

Holczbauer

et al. 2009

IMAS

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“…In patients with impaired renal function, IL‐2 antibodies (basiliximab) were used for induction therapy instead of calcineurin inhibitors until the creatinin clearance was above 50 ml/min [31]. A fixed scheme was used for all patients in the SEB [18] containing cyclosporine, azathioprine – later mycophenolate‐mophetile – and methylprednisolon while tacrolimus was used only occasionally and as secondary choice in case of proven hepatitis C recurrence [32]. Also, it appeared that cyclosporine levels were kept higher in SEB during the first 6 months: the target level was 300–400 μ g/ml in the SEB and up to 250 μ g/ml in UMCG for the 1–2 weeks, diminishing to 200 μ g/ml in SEB and to 100–150 μ g/ml in UMCG by the second month.…”

Section: Methodsmentioning

confidence: 99%

Analysis of differences in outcome of two European liver transplant centers

Nemes¹,

Polak²,

Ther³

et al. 2006

Transplant Int

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Summary Authors analyzed the differences in the outcome of two European liver transplant centers differing in case volume and experience. The first was the Transplantation and Surgical Clinic, Semmelweis University, Budapest, Hungary (SEB) and the second the University Medical Center Groningen, Groningen, The Netherlands (UMCG). We investigated if such differences could be explained. The 1‐, 3‐ and 5‐year patient survival in the UMCG was 86%, 80%, and 77% compared with 65%, 56%, and 55% in SEB. Graft survival at the same time points was 79%, 71%, and 66% in the UMCG and 62%, 55%, and 53% in SEB. Significant differences were present regarding the donor and recipient age, diagnosis mix, disease severity and operation variables, per‐operative transfusion rate, vascular complications, postoperative infection rate, and need for renal replacement. To determine factors correlating with survival, a separate uni‐ and multivariate analysis was performed in each center individually, between study parameters and patient survival. In both centers, peri‐operative red blood cell (RBC) transfusion rate was a significant predictor for patient survival. The difference in blood loss can be explained by different operation techniques and shorter operation time in SEB, with consequently less time spent on hemostasis. It was jointly concluded that measures to reduce blood loss by adapting the operation technique might lead to improved survival and reduced morbidity.

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“…Based on observations up to now, severity and course of recurrent hepatitis C are negatively influenced by a higher viral titre prior to transplantation; repeated intravenous steroid therapy; donors' age exceeding 50 years; steatosis of graft; and higher dosage of postoperative immunosuppressive therapy [10][11][12][13].…”

Section: Factors Influencing Recurrent Hcv Infectionmentioning

confidence: 99%

Treatment of recurrent hepatitis C virus infection in patients after liver transplantation

Lengyel¹,

Tulassay²

2009

Clinical and Experimental Medical Journal

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The main indication for liver transplantation is the final stage of hepatic cirrhosis developed due to hepatitis C virus (HCV) infection. The recurrence of HCV infection after transplantation is a common situation. Recurrent hepatitis C is a progressive disease; in 20% of patients it produces liver cirrhosis without treatment beside immunosuppression within 5 years. Treatment of recurrent HCV infection is the most important factor of survival in patients with transplantation. Based on literary data and their observations, the authors review the factors influencing the progression of recurrent HCV infection. They discuss in details the effect of immunosuppressive therapy, the importance of selecting appropriate immunosuppressive drugs. They review the key points in the diagnosis of recurrent hepatitis C; underline the decisive role of liver biopsy carried out according to protocol in the diagnosis, as well as the hard consultation between specialists of pathology, hepatology and surgery. They demonstrate their observations with the treatment of patients on the waiting list, the results of early pre-emptive treatment of recurrent chronic hepatitis, furthermore treatment modalities and results in patients with histologically proven chronic hepatitis C. The drug of choice for chronic hepatitis C after transplantation is combined therapy with pegylated interferon and ribavirin. This therapy is able to assure sustained virological negativity in 20-50% of patients. In virus-free patients the inflammatory activity in the liver significantly decreases, and the histologic activity index improves. There are data showing a fibrosis-inhibiting effect of the treatment, however, multicentric studies are required for their confirmation. No advantage of early antiviral treatment without histologic alteration has been confirmed by most of the trials. In this group of patients common side effects of the treatment include anaemia and neutropenia, and therefore administration of erythropoietin and granulocyte stimulating factor is recommended. Further research and clinical studies are required in order to establish optimal treatment of patients with recurrent hepatitis C, to determine the dosage of pegylated interferon and ribavirin, to decrease duration of therapy, to reduce side effects and finally to achieve the healing phase in a greater percentage of patients.

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Serum hepatitis C virus-ribonucleotide acid monitoring after liver transplantation

Cited by 9 publications

References 13 publications

Expression pattern of molecular chaperones after liver transplantation in hepatitis C positive recipients. Relation to serum HCV-RNA titers

Expression pattern of molecular chaperones after liver transplantation in hepatitis C positive recipients. Relation to serum HCV-RNA titers

Analysis of differences in outcome of two European liver transplant centers

Treatment of recurrent hepatitis C virus infection in patients after liver transplantation

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