Fibrosing cholestatic hepatitis C in post-transplant adult recipients of liver transplantation (EN)

Ogura, Yasuhiro

Kamei, Hideya

Ishigami, Masatoshi

Ishizu, Yoji

Hori, Tomohide

Onishi, Yasuharu

Kurata, Nobuhiko

Hepatitis C recurrence continues to present a major challenge in liver transplantation (LT). Approximately 10% of hepatitis C virus (HCV)-positive recipients will develop fibrosing cholestatic hepatitis (FCH) after LT. FCH is clinically characterized as marked jaundice with cholestatic hepatic dysfunction and high titers of viremia. Pathologically, FCH manifests as marked hepatocyte swelling, cholestasis, periportal peritrabecular fibrosis and only mild inflammation. This progressive form usually involves acute liver failure, and rapidly results in graft loss. A real-time and precise diagnosis based on histopathological examination and viral measurement is indispensable for the adequate treatment of FCH. Typical pathological findings of FCH are shown. Currently, carefully selected combinations of direct-acting antivirals (DAAs) offer the potential for highly effective and safe regimens for hepatitis C, both in the pre- and post-transplant settings. Here, we review FCH caused by HCV in LT recipients, and current strategies for sustained virological responses after LT. Only a few cases of successfully treated FCH C after LT by DAAs have been reported. The diagnostic findings and therapeutic dilemma are discussed based on a literature review.Keywords Fibrosing cholestatic hepatitis, hepatitis C, liver transplantation, intractable ascites, portal hypertensionAnn Gastroenterol 2016; 29 (4): 454-459 (EN)

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Ελληνική Γαστροεντερολογική Εταιρία

Annals of Gastroenterology

Review Articles

Αγγλική γλώσσα

2016-09-29

http://www.annalsgastro.gr/index.php/annalsgastro/article/view/2716

Hellenic Society of Gastroenterology (EN)

1792-7463

1108-7471

Annals of Gastroenterology; Volume 29, No 4 (2016); 454 (EN)