Severe fibrosis in patients with recurrent hepatitis C after liver transplantation: A French experience on 250 patients over 15 years (the Orfèvre study) - 17/06/14
, Ephrem Salamé b, 1, Bruno Roche c, 2, Monika Hurtova d, 2, Filomena Conti e, 2, Sylvie Radenne f, 2, Claire Vanlemmens g, 2, Georges-Philippe Pageaux h, 2, Faouzi Saliba c, 2, Didier Samuel c, 2, Philippe Compagnon i, 2, Martine Neau-Cransac j, 2, Yvon Calmus e, 2, Olivier Guillaud a, 2, Jean Gugenheim k, 2, Mario Altieri l, 2, François Durand m, 2, Jean Hardwigsen n, 2, Richard Lorho o, 2, Sébastien Dharancy p, 2, Vincent Leroy q, 2, Fabienne Di Giambattista r, 3, Christophe Duvoux d, 1Bienvenue sur EM-consulte, la référence des professionnels de santé.
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| Iconographies | 2 |
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Summary |
Background and aims |
Recurrent hepatitis C after liver transplantation (LT) is associated with rapid fibrosis progression. The aim of this study was to evaluate the cumulative risk for severe fibrosis and the factors influencing it.
Patients and methods |
Two hundred and fifty LT patients were included 1 to 15years after LT. Recurrence of chronic hepatitis C on liver graft was classified according to Metavir score.
Results |
Kaplan-Meyer estimates for actuarial progression to severe fibrosis (Metavir>F3) showed a probability of 15.2% and 44.5% at 5 and 10years, respectively. Predictive factors for progression to severe fibrosis were: use of tacrolimus as main CNI, recipient age at time of biopsy<55, donor age ≥45, graft HCV re-infection<3months, biologically suspected graft re-infection and lack of response to antiviral treatment after LT. Multivariate analysis disclosed that only donor age ≥45 (hazard ratio 2.243, 95%CI 1.264–3.983, P=0.0058) and lack of response to antiviral treatment (hazard ratio 2.816, 95%CI 1.227–6.464, P=0.0146) were associated to severe fibrosis.
Conclusions |
Our study confirms that donor age ≥45 and lack of response to antiviral treatment after LT are major predictive factors of progression of HCV recurrence on liver graft.
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Vol 38 - N° 3
P. 292-299 - juin 2014 Retour au numéro
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