Hepatitis C recurrence after liver transplantation

Hepatitis C-retated cirrhosis is the major indication for liver transplantation (LT). This disease recurs histologically in nearly all the HCV-infected patients during the first postoperative year. Chronic hepatitis C evolves to cirrhosis in 20% of the cases within 5 years after LT. However, the 5-year survival for a HCV-infected recipient is still comparable to that of a patient grafted for another indication ; it will become worse later. High vireniia after LT is associated with a more severe liver recurrent disease. The influence of viral genotype remains controversial. The impact of the type of immanosuppression on HCV recurrence is unclear. Steroids, that increase viremia, might have a deleterious effect on the outcome of chronic HCV-disease after LT. Antiviral combined therapy (Interferon + Ribavirin) soon after transplantation, before disease recurrence, is probably the best treatment at the present time; this remains still unproven. Retransplantation for HCV recurrent cirrhosis allows a 60% survival at I year. (Acta gastroeriterol. belg., 1999, 62, 428-431).