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Slowly tapering off steroids protects the graft against hepatitis C recurrence after liver transplantation

Slowly tapering off steroids protects the graft against hepatitis C recurrence after liver... Chronic hepatitis C represents a major clinical problem after liver transplantation, but factors influencing the recurrent disease have not been well characterized. We analyzed the clinical records of all the patients transplanted for hepatitis C virus (HCV)–related liver disease in our Center between 1991 and 1997. Eighty consecutive HCV‐positive (+) patients (60 men, ages 28 to 64) survived more than 1 month after transplantation and were followed for a median of 45 months. Diagnosis of recurrent chronic hepatitis C was made in 38 patients (47.5%), of whom 22 had moderate/severe chronic hepatitis. Decompensated cirrhosis occurred in six patients (7.5%). No difference in patient survival was found between patients with and without hepatitis C recurrence. No association was found between recurrent hepatitis C and presumed risk factors. The method of tapering off corticosteroids was significantly associated with both hepatitis C recurrence and the severity of hepatitis. In patients receiving a higher daily prednisone dose, 12 months after transplantation, the proportion of recurrent hepatitis C was 35.7% versus 66.6% (P = .02; odds ratio (OR), 3.6; 95% confidence interval (CI): 1.25 to 10.36), and among patients receiving a higher daily prednisone dose, 6 months after transplantation, the proportion of moderate/severe chronic hepatitis C was 40% versus 89% (P = .03; OR: 0.08, 95% CI: 0.008 to 0.84). Finally, prednisone dose at month six was significantly associated with disease‐free survival of the liver graft. In conclusion, our results seem to indicate that in HCV‐infected liver transplant recipients, a long‐term treatment with corticosteroids, slowly tapered off over time, may prevent the more aggressive forms of recurrent liver disease. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Liver Transplantation Wiley

Slowly tapering off steroids protects the graft against hepatitis C recurrence after liver transplantation

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References (14)

Publisher
Wiley
Copyright
Copyright © 2002 American Association for the Study of Liver Diseases
ISSN
1527-6465
eISSN
1527-6473
DOI
10.1053/jlts.2002.34640
pmid
12360428
Publisher site
See Article on Publisher Site

Abstract

Chronic hepatitis C represents a major clinical problem after liver transplantation, but factors influencing the recurrent disease have not been well characterized. We analyzed the clinical records of all the patients transplanted for hepatitis C virus (HCV)–related liver disease in our Center between 1991 and 1997. Eighty consecutive HCV‐positive (+) patients (60 men, ages 28 to 64) survived more than 1 month after transplantation and were followed for a median of 45 months. Diagnosis of recurrent chronic hepatitis C was made in 38 patients (47.5%), of whom 22 had moderate/severe chronic hepatitis. Decompensated cirrhosis occurred in six patients (7.5%). No difference in patient survival was found between patients with and without hepatitis C recurrence. No association was found between recurrent hepatitis C and presumed risk factors. The method of tapering off corticosteroids was significantly associated with both hepatitis C recurrence and the severity of hepatitis. In patients receiving a higher daily prednisone dose, 12 months after transplantation, the proportion of recurrent hepatitis C was 35.7% versus 66.6% (P = .02; odds ratio (OR), 3.6; 95% confidence interval (CI): 1.25 to 10.36), and among patients receiving a higher daily prednisone dose, 6 months after transplantation, the proportion of moderate/severe chronic hepatitis C was 40% versus 89% (P = .03; OR: 0.08, 95% CI: 0.008 to 0.84). Finally, prednisone dose at month six was significantly associated with disease‐free survival of the liver graft. In conclusion, our results seem to indicate that in HCV‐infected liver transplant recipients, a long‐term treatment with corticosteroids, slowly tapered off over time, may prevent the more aggressive forms of recurrent liver disease.

Journal

Liver Transplantation – Wiley

Published: Oct 1, 2002

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