Prolonged rewarming time during allograft implantation predisposes to recurrent hepatitis C infection after liver transplantation.

Journal Article (Journal Article)

The majority of patients undergoing orthotopic liver transplantation (OLT) have end-stage liver disease secondary to hepatitis C virus (HCV) infection. Although OLT does not cure the disease and recurrent virus is present in all patients, relatively few patients with recurrent viremia develop clinical disease. When the disease recurs, however, the results can be devastating. Factors associated with increased risk for recurrent HCV disease remain controversial. We hypothesized that preservation injury may predispose to the severity of HCV disease after OLT. We reviewed our series of OLTs performed for HCV cirrhosis between January 1994 and December 1998 (n = 56; 62 transplants). Patients were grouped according to the severity of recurrent hepatitis C. Group 1 had no or mild HCV disease (n = 36), and group 2 had moderate to severe HCV disease (n = 20). The duration of ischemic rewarming during graft implantation was significantly associated with the severity of recurrent hepatitis C (P <.04). The estimated chances of severe disease within the first year post-OLT after 30, 60, or 90 minutes of ischemic rewarming time were 19%, 40%, and 65%, respectively. Cold ischemia time, transaminase levels, and prothrombin time did not correlate with the severity of hepatitis C. In conclusion, our data suggest that the duration of ischemic rewarming predisposes to severe recurrent hepatitis C. This finding warrants the investigation of the pathogenesis of recurrent HCV disease after ischemic injury. Reduction of rewarming time should be stressed in OLT, particularly in patients with HCV cirrhosis.

Full Text

Duke Authors

Cited Authors

  • Baron, PW; Sindram, D; Higdon, D; Howell, DN; Gottfried, MR; Tuttle-Newhall, JE; Clavien, PA

Published Date

  • July 2000

Published In

Volume / Issue

  • 6 / 4

Start / End Page

  • 407 - 412

PubMed ID

  • 10915160

Pubmed Central ID

  • 10915160

International Standard Serial Number (ISSN)

  • 1527-6465

Digital Object Identifier (DOI)

  • 10.1053/jlts.2000.7581


  • eng

Conference Location

  • United States