XV Konferencja Naukowa Polskiego Towarzystwa Hepatologicznego
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Chronic hepatitis type C as an indication for liver retransplantation
Marta Wawrzynowicz-Syczewska
Medical Science Review - Hepatologia 2011; 11 57-59
aaICID: 970949
Article type: Review article
IC™ Value: 3.40
Abstract provided by Publisher
End-stage liver disease due to chronic HCV infection is a primary indication for
liver transplantation in Europe and in the United States. Graft reinfection is almost universal
and the natural history of HCV disease after transplantation is more rapid than in the immunocompetent
patients. Every third patient will develop liver cirrhosis in less than five years
posttransplant. Several factors have been implicated in more aggressive HCV disease course.
The most important include: older donor age, higher pretransplant viral load and the strength
of immunosuppression. Successful antiviral treatment with pegylated interferon and ribavirin
has a great impact on the graft survival, although modest results can arrest disease progression
in a subset. Retransplantation (reLT) in HCV-positive recipients is an area of particular controversy,
as obtained results are inferior in comparison with the first transplantation. Several
prognostic models have been proposed to help in the decision-making process of listing candidates
for reLT. It seems that early HCV-dependent cirrhosis recurrence (<1 year after primary
transplantation) should be a contraindication for reLT. Another variables with the highest
impact on survival include: recipient age >60 years, donor age >40 years, MELD >30, creatinine
level >2 mg% and bilirubin level >10 mg%.

ICID 970949

DOI 10.5604/17305039.970949

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