Cingles Info

By Peggy Peck
Special to DG News
WASHINGTON, DC -- April 29, 2002 -- Hepatitis C recurs significantly
sooner after living donor liver transplantation than after cadaver
liver transplantation and appears more likely to occur with smaller
grafts, researcher said at the American Transplant Congress,
Transplant 2002.
Masahiko Taniguchi, MD, and colleagues from the University of
Colorado Health Science Center, Denver, United States, reported that
average number of days "to HCV recurrence was about half as long
after living donor liver transplantation (LDLT) compared to cadaver
liver transplantation (CLT) recipients." This is a significant
consideration, said Dr. Taniguchi, since "55 percent of the LDLT
patients at our center are HCV patients. We think, therefore, that
LDLT may be unwise in a HCV patients."
Between April 1999 and November 2001, 55 patients underwent LDLT at
his center. Twenty-nine of these patients were HCV positive. During
the same period 59 HVC patients underwent CLT.
Diagnosis of recurrent HCV was based on increased transaminase levels
(AST), positive serum HCV-RNA, and histological findings on liver
biopsy. Graft size was standardized by the ratio of graft volume to
standard liver volume (GV/SV ratio). Peak level of total bilirubin
(peak T-bil) was used as an index of graft function, and the length
of stay was used as a measure of clinical course.
The average number of days until HCV recurrence was 90 among the LDLT
and 168 among the CLT patients.
"Longer length of stay and higher peak T-bil post-transplant were
both markers for early HCV recurrence," said Taniguchi. He said that
AST levels in patients with early HCV recurrence also "remained
consistently higher during the first 30 days post-transplant."
Taniguchi said that "in LDLT there is a possibility that the graft
fibrosis induced by HCV recurrence is accelerated by graft
regeneration and inflammation caused by poorer graft function in the
early stage after transplantation."
Asked if the results could be explained by more aggressive
immunosuppression sometimes used in LDLT, Taniguchi said the findings
did "not appear to be related to immunosuppression."