Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

Hepatitis C and liver transplantation

Nature volume 436, pages 973–978 (2005)Cite this article

Abstract

Liver transplantation is a life-saving therapy to correct liver failure, portal hypertension and hepatocellular carcinoma arising from hepatitis C infection. But despite the successful use of living donors and improvements in immunosuppression and antiviral therapy, organ demand continues to outstrip supply and recurrent hepatitis C with accelerated progression to cirrhosis of the graft is a frequent cause of graft loss and the need for retransplantation. Appropriate selection of candidates and timing of transplantation, coupled with better pre- and post-transplant antiviral therapy, are needed to improve outcomes.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1: The mathematical model MELD can predict the survival of candidates waiting for a liver transplant.
Figure 2: Survival benefit of pursuing live donor liver transplantation (LDLT).
Figure 3: Number of live donor liver transplants in the United States.
Figure 4: Management of hepatitis C and liver transplantation.

Similar content being viewed by others

References

  1. Brown, R. S. Jr & Lake, J. R. The survival impact of liver transplantation in the MELD era, and the future for organ allocation and distribution. Am. J. Transplant. 5, 203–204 (2005).

    Article  PubMed  Google Scholar 

  2. Olthoff, K. M. et al. Summary report of a national conference: evolving concepts in liver allocation in the MELD and PELD era. Liver Transplant. 10, A6–A22 (2004).

    Article  Google Scholar 

  3. Lucey, M. R. et al. Minimal criteria for placement of adults on the liver transplant waiting list: a report of a national conference organized by the American Society of Transplant Physicians and the American Association for the Study of Liver Diseases. Liver Transplant. Surg. 3, 628–637 (1997).

    Article  CAS  Google Scholar 

  4. Merion, R. M. et al. The survival benefit of liver transplantation. Am. J. Transplant. 5, 307–313 (2005).

    Article  PubMed  Google Scholar 

  5. Desai, N. M. et al. Predicting outcome after liver transplantation: utility of the model for end-stage liver disease and a newly derived discrimination function. Transplantation 77, 99–106 (2004).

    Article  PubMed  Google Scholar 

  6. Abt, P. L. et al. Allograft survival following adult-to-adult living donor liver transplantation. Am. J. Transplant. 4, 1302–1307 (2004).

    Article  PubMed  Google Scholar 

  7. Broelsch, C. E. et al. Liver transplantation in children from living related donors. Surgical techniques and results. Ann. Surg. 214, 428–437 (1991).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Brown, R. S. Jr et al. A survey of liver transplantation from living adult donors in the United States. N. Engl. J. Med. 348, 818–825 (2003).

    Article  PubMed  Google Scholar 

  9. Liu, C. L., Lam, B., Lo, C. M. & Fan, S. T. Impact of right-lobe live donor liver transplantation on patients waiting for liver transplantation. Liver Transplant. 9, 863–869 (2003).

    Article  Google Scholar 

  10. Russo, M. W., LaPointe-Rudow, D., Kinkhabwala, M., Emond, J. & Brown, R. S. Jr Impact of adult living donor liver transplantation on waiting time survival in candidates listed for liver transplantation. Am. J. Transplant. 4, 427–431 (2004).

    Article  PubMed  Google Scholar 

  11. Everson, G. T. Treatment of patients with hepatitis C virus on the waiting list. Liver Transplant. 9, S90–S94 (2003).

    Article  Google Scholar 

  12. Marcos, A. et al. Liver regeneration and function in donor and recipient after right lobe adult to adult living donor liver transplantation. Transplantation 69, 1375–1379 (2000).

    Article  CAS  PubMed  Google Scholar 

  13. Baltz, A. C. & Trotter, J. F. Living donor liver transplantation and hepatitis C. Clin. Liver Dis. 7, 651–665, viii (2003).

    Article  PubMed  Google Scholar 

  14. Russo, M. W., Galanko, J., Beavers, K., Fried, M. W. & Shrestha, R. Patient and graft survival in hepatitis C recipients after adult living donor liver transplantation in the United States. Liver Transplant. 10, 340–346 (2004).

    Article  Google Scholar 

  15. Shiffman, M. L. et al. Histologic recurrence of chronic hepatitis C virus in patients after living donor and deceased donor liver transplantation. Liver Transplant. 10, 1248–1255 (2004).

    Article  Google Scholar 

  16. Gaglio, P. J. et al. Increased risk of cholestatic hepatitis C in recipients of grafts from living versus cadaveric liver donors. Liver Transplant. 9, 1028–1035 (2003).

    Article  Google Scholar 

  17. Freeman, R. B. The impact of the model for end-stage liver disease on recipient selection for adult living liver donation. Liver Transplant. 9, S54–S59 (2003).

    Article  Google Scholar 

  18. Trotter, J. F. et al. Evaluation of 100 patients for living donor liver transplantation. Liver Transplant. 6, 290–295 (2000).

    Article  CAS  Google Scholar 

  19. Rudow, D. L., Russo, M. W., Hafliger, S., Emond, J. C. & Brown, R. S. Jr Clinical and ethnic differences in candidates listed for liver transplantation with and without potential living donors. Liver Transplant. 9, 254–259 (2003).

    Article  Google Scholar 

  20. Miller, C. et al. Fulminant and fatal gas gangrene of the stomach in a healthy live liver donor. Liver Transplant. 10, 1315–1319 (2004).

    Article  Google Scholar 

  21. Russo, M. W. & Brown, R. S. Jr Adult living donor liver transplantation. Am. J. Transplant. 4, 458–465 (2004).

    Article  PubMed  Google Scholar 

  22. Charlton, M. Natural history of hepatitis C and outcomes following liver transplantation. Clin. Liver Dis. 7, 585–602 (2003).

    Article  PubMed  Google Scholar 

  23. Garcia-Retortillo, M. et al. Hepatitis C virus kinetics during and immediately after liver transplantation. Hepatology 35, 680–687 (2002).

    Article  PubMed  Google Scholar 

  24. Berenguer, M. Natural history of recurrent hepatitis C. Liver Transplant. 8, S14–S18 (2002).

    Article  Google Scholar 

  25. Berenguer, M. et al. Natural history of clinically compensated hepatitis C virus-related graft cirrhosis after liver transplantation. Hepatology 32, 852–858 (2000).

    Article  CAS  PubMed  Google Scholar 

  26. Cescon, M. et al. Long-term survival of recipients of liver grafts from donors older than 80 years: is it achievable? Liver Transplant. 9, 1174–1180 (2003).

    Article  Google Scholar 

  27. Zhao, Y., Lo, C. M., Liu, C. L. & Fan, S. T. Use of elderly donors (> 60 years) for liver transplantation. Asian J. Surg. 27, 114–119 (2004).

    Article  PubMed  Google Scholar 

  28. Machicao, V. I. et al. Donor age affects fibrosis progression and graft survival after liver transplantation for hepatitis C. Transplantation 77, 84–92 (2004).

    Article  PubMed  Google Scholar 

  29. Arenas, J. I., Vargas, H. E. & Rakela, J. The use of hepatitis C-infected grafts in liver transplantation. Liver Transplant. 9, S48–S51 (2003).

    Article  Google Scholar 

  30. Saab, S. et al. Outcomes of hepatitis C and hepatitis B core antibody-positive grafts in orthotopic liver transplantation. Liver Transplant. 9, 1053–1061 (2003).

    Article  Google Scholar 

  31. Saab, S. et al. Hepatitis C positive grafts may be used in orthotopic liver transplantation: a matched analysis. Am. J. Transplant. 3, 1167–1172 (2003).

    Article  PubMed  Google Scholar 

  32. Charlton, M. et al. Predictors of patient and graft survival following liver transplantation for hepatitis C. Hepatology 28, 823–830 (1998).

    Article  CAS  PubMed  Google Scholar 

  33. Charlton, M. et al. Long-term results and modeling to predict outcomes in recipients with HCV infection: results of the NIDDK liver transplantation database. Liver Transplant. 10, 1120–1130 (2004).

    Article  Google Scholar 

  34. Ghobrial, R. M. et al. A 10-year experience of liver transplantation for hepatitis C: analysis of factors determining outcome in over 500 patients. Ann. Surg. 234, 384–393; discussion 393–394 (2001).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Terrault, N. A. Hepatitis C virus and liver transplantation. Semin. Gastrointest. Dis. 11, 96–114 (2000).

    CAS  PubMed  Google Scholar 

  36. Zervos, X. A. et al. Comparison of tacrolimus with microemulsion cyclosporine as primary immunosuppression in hepatitis C patients after liver transplantation. Transplantation 65, 1044–1046 (1998).

    Article  CAS  PubMed  Google Scholar 

  37. Wiesner, R. et al. A randomized double-blind comparative study of mycophenolate mofetil and azathioprine in combination with cyclosporine and corticosteroids in primary liver transplant recipients. Liver Transplant. 7, 442–450 (2001).

    Article  CAS  Google Scholar 

  38. Jain, A. et al. A prospective randomized trial of mycophenolate mofetil in liver transplant recipients with hepatitis C. Liver Transplant. 8, 40–46 (2002).

    Article  Google Scholar 

  39. Nelson, D. R. et al. Anti-interleukin-2 receptor therapy in combination with mycophenolate mofetil is associated with more severe hepatitis C recurrence after liver transplantation. Liver Transplant. 7, 1064–1070 (2001).

    Article  CAS  Google Scholar 

  40. Charlton, M. & Seaberg, E. Impact of immunosuppression and acute rejection on recurrence of hepatitis C: results of the National Institute of Diabetes and Digestive and Kidney Diseases Liver Transplantation Database. Liver Transplant. Surg. 5, S107–S114 (1999).

    Article  CAS  Google Scholar 

  41. Eason, J. D., Nair, S., Cohen, A. J., Blazek, J. L. & Loss, G. E. Jr. Steroid-free liver transplantation using rabbit antithymocyte globulin and early tacrolimus therapy. Transplantation 75, 1396–1369 (2003).

    Article  CAS  PubMed  Google Scholar 

  42. Shiffman, M. L. et al. Peginterferon α2a and ribavirin in patients with chronic hepatitis C who have failed prior treatment. Gastroenterology 126, 1015–1023 (2004).

    Article  CAS  PubMed  Google Scholar 

  43. Crippin, J. S., McCashland, T., Terrault, N., Sheiner, P. & Charlton, M. R. A pilot study of the tolerability and efficacy of antiviral therapy in hepatitis C virus-infected patients awaiting liver transplantation. Liver Transplant. 8, 350–355 (2002).

    Article  Google Scholar 

  44. Everson, G. T. Should we treat patients with chronic hepatitis C on the waiting list? J. Hepatol. 42, 456–462 (2005).

    Article  PubMed  Google Scholar 

  45. Everson, G. T. Treatment of chronic hepatitis C in patients with decompensated cirrhosis. Rev. Gastroenterol. Disord. 4 (suppl. 1), S31–S38 (2004).

    PubMed  Google Scholar 

  46. Gane, E. Treatment of recurrent hepatitis C. Liver Transplant. 8, S28–S37 (2002).

    Article  Google Scholar 

  47. Ahmad, J., Dodson, S. F., Demetris, A. J., Fung, J. J. & Shakil, A. O. Recurrent hepatitis C after liver transplantation: a nonrandomized trial of interferon α alone versus interferon α and ribavirin. Liver Transplant. 7, 863–869 (2001).

    Article  CAS  Google Scholar 

  48. Lavezzo, B. et al. Treatment of recurrent hepatitis C in liver transplants: efficacy of a six versus a twelve month course of interferon α2b with ribavirin. J. Hepatol. 37, 247–252 (2002).

    Article  CAS  PubMed  Google Scholar 

  49. Samuel, D. et al. Interferon-α2b plus ribavirin in patients with chronic hepatitis C after liver transplantation: a randomized study. Gastroenterology 124, 642–650 (2003).

    Article  CAS  PubMed  Google Scholar 

  50. Chalasani, N. et al. Peginterferon α2a for hepatitis C after liver transplantation: two randomized, controlled trials. Hepatology 41, 289–298 (2005).

    Article  CAS  PubMed  Google Scholar 

  51. Rodriguez-Luna, H. et al. Treatment of recurrent hepatitis C infection after liver transplantation with combination of pegylated interferon α2b and ribavirin: an open-label series. Transplantation 77, 190–194 (2004).

    Article  CAS  PubMed  Google Scholar 

  52. Ross, A. S. et al. Pegylated interferon α2b plus ribavirin in the treatment of post-liver transplant recurrent hepatitis C. Clin. Transplant. 18, 166–173 (2004).

    Article  ADS  PubMed  Google Scholar 

  53. Saab, S. et al. Outcomes of acute rejection after interferon therapy in liver transplant recipients. Liver Transplant. 10, 859–867 (2004).

    Article  Google Scholar 

  54. Toniutto, P. et al. Pegylated versus standard interferon-α in antiviral regimens for post-transplant recurrent hepatitis C: comparison of tolerability and efficacy. J. Gastroenterol. Hepatol. 20, 577–582 (2005).

    Article  CAS  PubMed  Google Scholar 

  55. Stravitz, R. T. et al. Effects of interferon treatment on liver histology and allograft rejection in patients with recurrent hepatitis C following liver transplantation. Liver Transplant. 10, 850–858 (2004).

    Article  Google Scholar 

  56. Wiesner, R. H., Sorrell, M. & Villamil, F. Report of the first International Liver Transplantation Society expert panel consensus conference on liver transplantation and hepatitis C. Liver Transplant. 9, S1–S9 (2003).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Medicine and Surgery, and Center for Liver Disease and Transplantation, Columbia University College of Physicians and Surgeons, 622 West 168th Street, New York, 10032, New York, USA

    Robert S. Brown Jr

Authors
  1. Robert S. Brown Jr
    View author publications

    You can also search for this author in PubMed Google Scholar

Ethics declarations

Competing interests

The author declares no competing financial interests.

Additional information

Author Information Reprints and permissions information is available at npg.nature.com/reprintsandpermissions.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Brown, R. Hepatitis C and liver transplantation. Nature 436, 973–978 (2005). https://doi.org/10.1038/nature04083

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nature04083

This article is cited by

Comments

By submitting a comment you agree to abide by our Terms and Community Guidelines. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate.

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing