Strategies to treat interferon-induced graft dysfunction after living donor liver transplantation for hepatitis C

Toru Ikegami, Huanlin Wang, Tomoharu Yoshizumi, Takeo Toshima, Shinichi Aishima, Takasuke Fukuhara, Norihiro Furusyo, Kazuhiro Kotoh, Shinji Shimoda, Ken Shirabe, Yoshihiko Maehara

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Abstract

Purpose: Interferon-induced graft dysfunction (IGD) is a poorly defined, unrecognized, but potentially serious condition for patients receiving antiviral drugs after liver transplantation for hepatitis C. Methods: We evaluated the characteristics of 80 patients who received pegylated interferon-based antiviral treatment for hepatitis C after living donor liver transplantation (LDLT). Results: Eight patients experienced IGD either during (n = 6) or after completing (n = 2) antiviral treatment. Pathological diagnosis included acute cellular rejection (ACR, n = 1), plasma cell hepatitis (PCH, n = 2), PCH plus ACR (n = 3), and chronic rejection (CR, n = 2). One patient with CR initially presented with PCH plus ACR and the other presented with ACR; both had apparent cholestasis. The six patients with ACR or PCH without cholestasis were successfully treated by discontinuing antiviral treatment and increasing immunosuppression, including steroids. By contrast, both of the patients with CR and cholestasis experienced graft loss, despite aggressive treatment. Univariate analysis showed that pegylated interferon-α2a-based treatment (75 vs. 26.4 %, p < 0.01) was the only significant factor for IGD, and was associated with decreased 5-year graft survival (93.4 vs. 71.4 %, p = 0.04). Conclusions: IGD is a serious condition during or even after antiviral treatment for hepatitis C after LDLT. Early recognition, diagnosis, discontinuation of interferon, and introduction of steroid-based treatment may help to save the graft.

Original languageEnglish
Pages (from-to)285-292
Number of pages8
JournalHepatology International
Volume8
Issue number2
DOIs
Publication statusPublished - Jan 1 2014

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Living Donors
Hepatitis C
Liver Transplantation
Interferons
Transplants
Antiviral Agents
Cholestasis
Therapeutics
Steroids
Graft Survival
Plasma Cells
Immunosuppression
Hepatitis
Early Diagnosis

All Science Journal Classification (ASJC) codes

  • Hepatology

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Strategies to treat interferon-induced graft dysfunction after living donor liver transplantation for hepatitis C. / Ikegami, Toru; Wang, Huanlin; Yoshizumi, Tomoharu; Toshima, Takeo; Aishima, Shinichi; Fukuhara, Takasuke; Furusyo, Norihiro; Kotoh, Kazuhiro; Shimoda, Shinji; Shirabe, Ken; Maehara, Yoshihiko.

In: Hepatology International, Vol. 8, No. 2, 01.01.2014, p. 285-292.

Research output: Contribution to journalArticle

Ikegami, Toru ; Wang, Huanlin ; Yoshizumi, Tomoharu ; Toshima, Takeo ; Aishima, Shinichi ; Fukuhara, Takasuke ; Furusyo, Norihiro ; Kotoh, Kazuhiro ; Shimoda, Shinji ; Shirabe, Ken ; Maehara, Yoshihiko. / Strategies to treat interferon-induced graft dysfunction after living donor liver transplantation for hepatitis C. In: Hepatology International. 2014 ; Vol. 8, No. 2. pp. 285-292.
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