Outcome and Management of Hepatitis C in Liver Transplant Recipients

Hepatitis C virus (HCV)–related cirrhosis is the leading indication for liver transplantation. Reinfection of the allograft with HCV is universal in all patients with pretransplantation viremia, and leads to histologically proven hepatitis in 50%–80% of these patients. Recent data have demonstrated significantly higher mortality among HCV-positive liver transplant recipients. For this subgroup of patients, retransplantation remains highly controversial. As current antiviral therapy is limited in efficacy and tolerability, an improved understanding of those patients at greatest risk of developing serious HCV-induced graft injury is necessary to optimize treatment. Hepatitis C virus (HCV)-related liver disease is the leading indication for orthotopic liver transplantation (OLT) world-wide. HCV reinfection after OLT universally occurs in patients with pretransplantation viremia, and 50%–80 % of these pa-tients develop hepatitis in the graft [1]. The diagnosis is made on the basis of the presence of HCV-RNA in the serum and/ or liver. Although most studies demonstrate that graft and pa-tient survival for the first decade after OLT appears to be un-affected by the HCV serostatus of the recipient, these analyse