New Insights in Recurrent HCV Infection after Liver Transplantation

Hsu, Shih-Hsien; Yeh, Ming-Lun; Wang, Shen-Nien

One study, reviewing 307 patients who underwent LT for HCV over a 10-year period, suggested that advanced donor age, prolonged donor hospitalization, increasing recipient age, and elevated recipient MELD scores were found to increase the relative risk of HCV recurrence [9] . Moreover, earlier studies have advocated that HCV recurrence may be more severe when older donors are used [10, 11] . In addition, the type of donor used may have an impact on HCV reinfection of the graft after LT. One clinical observation suggested that HCV recurrence is more severe in living donor LT compared to cadaveric LT [12] . However, another study reported that there are no differences observed in hepatitis C recurrence rate, severity of intrahepatic pathology, or graft and patient survival between living donor LT and cadaveric LT recipients [13] . As to the source of HCV reinfection in the allograft, it may occur at time of reperfusion intraoperatively [3] . The blood itself has a high probability to be the origin of this allograft reinfection [4] . It is indeed valuable that identifying these risk factors before LT, particularly when matching donors to HCV recipients, may decrease the incidence of HCV recurrence after LT.