Hepatitis C virus (HCV) is the most common indication for liver transplantation (LT).Recently, reports from some centers have suggested that partial liver transplants and moreover living related liver transplantation (LRLT) may be associated with an increased risk for HCV recurrence.The aim of this study is to compare HCV recurrence in adult recipient after in situ Split Liver Transplantation (SLT) versus Whole Liver Transplant (WLT).From June 1998 to February 2004, whitin our institution 220 first liver transplants were performed for adult recipients. Of these 153 (69.5%) were WLT, 56 (25.4%) Adult to Paediatric SLT (SLT A/P) and 11(5%) adult to adult SLT (SLT A/A).Overall HCV cirrhosis accounted for 43.6%; of those we considered the first 64 recipients who recived a LT for HCV-induce liver disease from June 6,1998, to October 10, 2002. Of these 18 (28.1%) received a right liver graft from SLT A/P and 46 (71.8%) received WLT. The mean follow-up was 50.4 months.Donor and recipients patterns were comparable. P value were significant only for increased donor age (P=0.000013) and shorter cold ischemic times (P=0.033) in WLT. The mean Graft recipient weight ratio in SLT group was 1.79.During follow-up HCV RNA resulted positive in 45 (97.8%) of 46 patients undergoing WLT and in all (100%) patients undergoing SLT (P=0.532) Where clinical indicated a liver biopsy were performed and proven histologic recurrence (Ishak Score System) in the two groups were: WLT, 67.3%; SLT, 61.1% (P=0.637). Severe recurrence (SR) presented with clinical decompensation associated or not to biopsy-proven cirrhosis were: 11/64 (24%) in the patients transplanted with WLT and 4/18 (22.2%) of SLT (P=0.853). Re transplantation was needed in 5.5% of SLT group and in 6.5% WLT (P=0.887). At a follow-up period of 50.4 months, in our experience there is no difference in HCV recurrence rate between WLT and SLT groups.
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|Titolo:||Is hepatitis C recurrence more severe after split liver graft compared to whole size graft?|
|Data di pubblicazione:||2006|
|Appare nelle tipologie:||01.05 - Abstract su rivista|