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More on Hepatitis C and Liver Transplants

Posted Jan 12 2010 12:00am
Hepatitis C virus (HCV)-related liver disease is the leading indication for orthotopic liver transplantation (OLT) worldwide. Recurrent HCV infection-defined by viremia after transplantation-is nearly universal, with histologic evidence of recurrent hepatitis present in the majority of patients. Although short-term survival is similar for patients transplanted for other causes of liver failure, approximately 20 to 25% of HCV-positive patients develop allograft cirrhosis by 5 years. Currently, there are no proven antiviral therapies that prevent HCV recurrence or development of allograft cirrhosis. Therefore, retransplantation is often the only viable option for patients with recurrent HCV-related liver disease. However, the outcome after retransplantation for HCV recurrence is poor, and whether organs should be offered to patients whose first allograft is failing because of recurrent HCV disease remains highly controversial. This review will highlight recent information regarding the long-term results of liver transplantation for HCV-related liver disease, the role of antiviral therapy, and the outcome after retransplantation.



Hepatitis C is a form of liver inflammation that causes primarily a long-lasting (chronic) disease. Acute (newly developed) hepatitis C is rarely observed as the early disease is generally quite mild. patients fare about as well over the decade following the procedure as do patients receiving liver transplants to ameliorate other conditions.

More than one-third of the livers transplanted in the United States go to hepatitis C patients.

Researchers tracked the progress of liver transplants in 135 people with hepatitis C and 608 people with other liver diseases. After 10 years, 67 percent of the hepatitis C patients were still alive, compared with 59 percent of the others, scientists report in the September Liver Transplantation . People with liver cancer or hepatitis B fared the worst.

Previous studies had suggested that liver transplants in hepatitis C patients were more likely to fall because the virus remains in the body even after a person's liver is replaced, says study coauthor Russel H. Wiesner, a hepatologist at the Mayo Clinic in Rochester, Minn. Indeed, the main cause of liver problems following a transplant in hepatitis C patients is the virus.

The new study shows that any life-threatening problem occurring in patients with hepatitis C generally came several years after transplant surgery. In the first 90 days after the operation, hepatitis C virus wasn't responsible for any of the severe health problems that occurred. They were usually caused by other infections or the failure of the transplanted organ to thrive.


What happens during transplant surgery?
Liver transplant surgery takes between six and 12 hours. During the operation, doctors remove the diseased liver and replace it with the donated liver. Most patients stay in the hospital for up to three weeks after surgery.
What are the side effects of a liver transplant?
The most common side effects are caused by the drugs that treat or prevent rejection. These side effects can include fluid retention, raised blood pressure, headaches, diarrhea and nausea. The severity of these side effects varies among patients.
What lifestyle changes are associated with liver transplants?
Most patients can return to a normal or near-normal lifestyle six months to a year after a successful liver transplant. When practical, transplant recipients should avoid exposure to people with infections. Maintaining a balanced diet, getting regular exercise and staying on prescribed medications are all important ways to stay healthy.
What is the outlook for liver transplant patients?
The outlook for patients is often expressed as a five-year survival rate. This refers to the percentage of liver transplant patients who are still alive five years after their transplant. The five-year survival rate for liver transplant patients is about 75 percent. Patients who receive livers from living donors have a slightly higher survival rate than patients whose livers came from deceased donors.
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