Long-Term outcome of hepatitis c infection acquired following pediatric liver transplantation

September 21, 2011

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Long-Term outcome of hepatitis c infection acquired following pediatric liver

transplantation

†C Venturi1, J Bueno2,*,‡, L Castells3, J Quintero4, I Casas2, H de5, V

ez-Ibañez6, R Charco1,7

DOI: 10.1002/lt.22439

Issue

Liver Transplantation

Accepted Article (Accepted, unedited articles published online for future

issues)

Abstract

The outcome and characterization of HCV infection following pediatric liver

transplantation (LT) have rarely been reported. We describe our experience in

HCV infection following pediatric LT. Of 207 children who underwent LT at our

institution (1985-2010), 10 (4.7%) developed previously-undiagnosed HCV disease.

Eight received a liver graft before the screening of blood products and donors

for HCV became available. Mean age at transplant was 8.9 + 4.3 years and median

time to HCV diagnosis following transplantation 15.8 years (range: 0.2-19

years). Genotypes were 1 (n=8), 3 (n=1) and undetermined (n=1). All patients are

alive with a mean follow-up after HCV diagnosis of 7.3 + 5.5 years. Five

patients did not receive treatment; of these, 2 reached spontaneous viral

clearance (SVC). Regarding treated patients, 4/5 achieved sustained viral

response, 3 of them with early viral response (EVR). Two of four patients

developed chronic rejection while on treatment resolved with conversion from

cyclosporine to tacrolimus. The remaining patient continues on treatment and has

also achieved EVR. In conclusion, despite the limitations of our series, de novo

HCV infection following pediatric LT seems to have slow histologic progression,

with good long-term prognosis and response to treatment, even in cases of

genotype 1. Nevertheless, chronic rejection during antiviral therapy may

2011 AASLD.

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