Risk factors for recurrence of hepatitis C after liver transplantation

Liver Transpl Surg. 1998 Jul;4(4):265-70. doi: 10.1002/lt.500040406.


Recurrent hepatitis C is a frequent complication after liver transplantation for hepatitis C virus-related cirrhosis, but risk factors related to its development remain ill defined. Twenty-three patients receiving a primary liver graft for hepatitis C virus-related cirrhosis and with an assessable biopsy performed at least 6 months after liver transplantation were studied retrospectively. The end point of this study was to look for risk factors associated with the development of histologic hepatitis C in the graft. Thirty-six major variables were studied, and those reaching significance by univariate analysis were included in a multivariate analysis. Eighteen patients (78%) developed posttransplant hepatitis C. On univariate analysis, six variables showed significant predictive value: increased immunosuppression for treatment of acute rejection; pretransplant hepatocellular carcinoma; cumulative doses of prednisone at 3, 6, and 12 months after transplantation; and mean blood trough levels of cyclosporine in the first 6 months posttransplantation. On multivariate analysis, two variables retained independent statistical significance as predictors of hepatitis C recurrence, namely receipt of antirejection therapy (P = .0087) and lower mean cyclosporine levels in the first 6 months after transplantation (P = .0134). Therefore, recurrence of hepatitis C after liver transplantation seems to be at least partially related to posttransplantation immunosuppressive therapy.

MeSH terms

  • Adult
  • Biopsy
  • Cyclosporine / therapeutic use
  • Female
  • Follow-Up Studies
  • Graft Rejection / pathology
  • Graft Rejection / prevention & control
  • Hepacivirus / genetics
  • Hepatitis C / enzymology
  • Hepatitis C / etiology*
  • Hepatitis C / pathology
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Liver Transplantation / adverse effects*
  • Liver Transplantation / pathology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Postoperative Complications
  • Predictive Value of Tests
  • RNA, Viral / analysis
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Transaminases / blood


  • Immunosuppressive Agents
  • RNA, Viral
  • Cyclosporine
  • Transaminases