J Korean Soc Transplant.  2012 Dec;26(4):269-276. 10.4285/jkstn.2012.26.4.269.

Liver Transplantation for Hepatitis C Virus-Related Liver Disease in Korea

Affiliations
  • 1Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. kwleegs@gmail.com
  • 2Department of Surgery, Seoul National University Boramae Hospital, Seoul, Korea.
  • 3Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
  • 4Department of Surgery, University of Ulsan College of Medicine, Seoul, Korea.
  • 5Department of Surgery, Catholic University of Daegu School of Medicine, Daegu, Korea.
  • 6Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 7Center for Liver Cancer, National Cancer Center, Goyang, Korea.
  • 8Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
  • 9Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.

Abstract

BACKGROUND
A management protocol for hepatitis C virus (HCV) after liver transplantation (LT) has not been established in Korea. We therefore investigated HCV transplant protocols and post-transplant results from liver transplant centers in Korea.
METHODS
The HCV protocol and medical data of individual cases from eight major liver transplant centers were compiled and analyzed.
RESULTS
A post-transplant protocol biopsy was performed in only three centers. In these centers, HCV treatment was considered when pathological abnormalities were confirmed on the protocol biopsy (irrespective of liver function). In the other five centers, biopsies were performed when biochemical parameters were aggravated. Only two out of the eight centers performed preemptive or prophylactic therapy. A total of 5,663 adult LTs were performed between 2000 and 2010. HCV-related liver disease was responsible for 277 LTs (4.9%). Pre-transplant data were not available in many patients, including HCV genotype and serum HCV RNA level. Tacrolimus was more frequently used for initial maintenance immunosuppression than cyclosporine A (61.7% vs. 36.8%). Post-transplant HCV treatment was performed in 135 patients (48.7%). Sixty-seven recipients (24.2%) died during follow-up after LT and 11 HCV-related graft loss (4.0%) developed. The cumulative patient survival rate was 74.7% at 5 years and 67.9% at 10 years after LT.
CONCLUSIONS
The HCV management protocol after LT varied markedly between the eight Korean transplant centers and a standard protocol did not exist. A nationwide multicenter study is required to investigate the most effective treatment for HCV after LT, with the goal of establishing the most effective standard protocol.

Keyword

Hepatitis C virus; HCV recurrence; Liver transplantation; Prophylaxis
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