Viral load 1 week after liver transplantation, donor age and rejections correlate with the outcome of recurrent hepatitis C

Ciccorossi, P.; Maina, Anna Maria; Oliveri, Filippo; Petruccelli, S; Leandro, Gioacchino; Colombatto, P.; Moriconi, F.; Mosca, Franco; Filipponi, Franco; Bonino, Ferruccio; Brunetto, Maurizia Rossana

doi:10.1111/j.1478-3231.2007.01459.x

Cited by 32 publications

(16 citation statements)

References 37 publications

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“…Our results showed that Hepatitis C viral load before and after transplant (3–6 months) is highly significant factors affecting HCV recurrence after liver transplantation ( P < 0.003 and P < 0.001 resp.). In this context, the current results support earlier reports of Khettry et al [30] and Ciccorossi et al [31] that high viral load pre-LT was correlated with more progressive recurrence of HCV and higher early (1 week) posttransplantation viral loads (≥2.5 × 10 5 IU/mL) are at risk for significant recurrent hepatitis C. These data suggest that patients who are at risk for significant HCV recurrence can be identified early.…”

Section: Discussionsupporting

confidence: 91%

Predictors of Disease Recurrence Post Living Donor Liver Transplantation in End Stage Chronic HCV Patients

et al. 2014

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HCV recurrence represents a universal phenomenon after liver transplantation. In this study Fifty HCV patients who underwent living donor liver transplantation were enrolled and factors that may accelerate HCV reinfection of the allograft such as donor's age and degree of liver steatosis, recipient's age, gender, BMI, MELD score, liver functions, HCV viral load, type of immunosuppressive drug, and genetic polymorphisms of IL28B, OAS, and IL1B were studied. The results of disease-free survival (DFS) rates showed inverse correlation with the recipient's postoperative levels of ALT, AST, ALP (P < 0.001, <0.001, and 0.006 resp.) as well as pre- and postoperative titers of HCV RNA (P < 0.003 and <0.001 resp.). Recipient's IL28B SNP was a significant factor in predicting postoperative DFS (P < 0.025). However, SNPs in OAS and IL1B genes had no apparent correlation with DFS. Cox proportional hazards model revealed that patients with elevated levels of ALT, preoperative viral titers, IL28B CT, and IL28B TT were 8.28, 4.22, 3.35, and 1.36 times, respectively, more likely to develop recurrence. In conclusion IL28B SNP, ALT level, and preoperative HCV titer besides proper choice of immunosuppressant are helpful for predicting posttransplant HCV recurrence and DFS.

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Section: Discussionsupporting

confidence: 91%

Predictors of Disease Recurrence Post Living Donor Liver Transplantation in End Stage Chronic HCV Patients

et al. 2014

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“…Many variables can impact patient and/or graft survival (12, 13, 16–23). In this study, we found recipient and donor age, female recipient gender, and treatment for acute rejection were also associated with severe fibrosis.…”

Section: Discussionmentioning

confidence: 99%

Racial Differences in Fibrosis Progression After HCV-Related Liver Transplantation

et al. 2012

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Background Black recipients undergoing liver transplantation (LT) for hepatitis C virus (HCV) have decreased patient and graft survival compared to white recipients, a finding which is primarily limited to black recipients of livers from white donors. The cause(s) for these discrepant outcomes are unclear but may be related to HCV disease recurrence. The rates of HCV-related disease recurrence and liver fibrosis progression among black and white LT recipients have not been investigated. Methods In this study, we compared liver fibrosis progression between 105 black and 364 white recipients after HCV-related LT in a multi-site cohort study and assessed the impact of donor race. Results At 6, 12 and 24 months after LT, there was a significantly higher percentage in the black (B) recipient/white (W) donor group with severe fibrosis, defined as stage 3 or 4 (F3/F4), compared to all other recipient/donor race combinations. The adjusted odds ratio of developing F3/F4 for the B/W group was 2.54 (1.49–4.69; reference group W/W). Black recipients with black donors had a similar rate of progression to F3/F4 as white recipients. Patient survival was also decreased in the B/W group compared to other recipient/donor race combinations. Conclusion African American recipients with white donors have more severe fibrosis progression after HCV related LT. The mechanisms responsible for accelerating fibrosis progression in this high-risk race-mismatched group need to be investigated.

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“…Donation following cardiac death, donation from older individuals, or from those with steatotic livers is becoming an increasingly common practice around the world 15‐17. The reports demonstrating that advanced donor age is associated with more aggressive recurrence of HCV and early allograft failure in HCV‐positive liver transplant recipients highlights the need to evaluate the quality of hepatocytes from various donor sources, particularly those harvested from the livers of individuals selected on the basis of extended donor criteria 4, 18, 19. Such reports are consistent with our data, demonstrating that hepatocytes isolated from older donors (≥60 years) had lower viability and posttransplant engraftment ( P ≤ 0.01).…”

Section: Discussionmentioning

confidence: 99%

Factors affecting hepatocyte isolation, engraftment, and replication in an in vivo model

et al. 2010

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Human hepatocyte transplantation is an alternative treatment for acute liver failure and liver diseases involving enzyme deficiencies. Although it has been successfully applied in selected recipients, both isolation and transplantation outcomes have the potential to be improved by better donor selection. This study assessed the impact of various donor variables on isolation outcomes (yield and viability) and posttransplant engraftment, using the SCID/Alb-uPA (severe combined immunodeficient/urokinase type plasminogen activator under the control of an albumin promoter) human liver chimeric mouse model. Human hepatocytes were obtained from 90 human liver donor specimens and were transplanted into 3942 mice. Multivariate analysis revealed improved viability with younger donors (P ¼ 0.038) as well as with shorter warm ischemic time (P ¼ 0.012). Hepatocyte engraftment, assessed by the posttransplant level of serum human a1-antitrypsin, was improved with shorter warm ischemia time. Hepatocytes isolated from older donors (!60 years) had lower viability and posttransplant engraftment (P 0.01). In conclusion, the selection of young donors (<60 years) and rapid liver specimen retrieval, allowing for shorter warm ischemia time, are key determinants for the success of both the isolation of high viability human hepatocytes and their subsequent posttransplantation capacity for engraftment and expansion. Liver Transpl 16:974-982,

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Viral load 1 week after liver transplantation, donor age and rejections correlate with the outcome of recurrent hepatitis C

Abstract: Early post-LT HCV-RNA correlates with the severity of hepatitis C recurrence and in combination with donor age (>60 years) and rejections, identifies patients with a high risk of severe recurrence and candidates of cost-effective pre-emptive antiviral therapy.

Cited by 32 publications

References 37 publications

Predictors of Disease Recurrence Post Living Donor Liver Transplantation in End Stage Chronic HCV Patients

Predictors of Disease Recurrence Post Living Donor Liver Transplantation in End Stage Chronic HCV Patients

Racial Differences in Fibrosis Progression After HCV-Related Liver Transplantation

Factors affecting hepatocyte isolation, engraftment, and replication in an in vivo model

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