✦ LIBER ✦

Outcomes of acute rejection after interferon therapy in liver transplant recipients

✍ Scribed by Sammy Saab; Denise Kalmaz; Nupoor A. Gajjar; Jonathan Hiatt; Francisco Durazo; Steven Han; Douglas G. Farmer; R. Mark Ghobrial; Hasan Yersiz; Leonard I. Goldstein; Charles R. Lassman; Ronald W. Busuttil

Publisher: John Wiley and Sons
Year: 2004
Tongue: English
Weight: 229 KB
Volume: 10
Category: Article
ISSN: 1527-6465
DOI: 10.1002/lt.20157

No coin nor oath required. For personal study only.

✦ Synopsis

Interferon alfa has been increasingly used against recurrent hepatitis C (HCV) disease in post-liver transplant (LT) recipients. A serious potential adverse effect is acute rejection. We reviewed our experience using interferonbased therapy (interferon or pegylated interferon with or without ribavirin) for treating recurrent HCV in LT recipients. Forty-four LT recipients were treated with interferon for recurrent HCV. Five of the 44 patients developed acute rejection during interferon-based therapy. These 5 patients started treatment of 42.4 ؎ 33.89 months (mean ؎ SD) after LT. Mean (؎ SD) histological activity index and fibrosis scores before initiating antiviral therapy were 8.8 (؎ 1.92) and 2.6 (؎ 0.55), respectively. Patients were treated for 3.3 ؎ 2.28 months (mean ؎ SD) prior to rejection. At the time of rejection, HCV load was not detectable in 4 of the 5 recipients. All 5 patients had tolerated interferon therapy, and none had stopped therapy because of adverse effects. The rejection was successfully treated in 3 patients. In 2 of those 3 patients, cirrhosis eventually developed. In the 2 patients who did not respond to rejection treatment, immediate graft failure occurred, leading to re-LT in 1 patient and death from sepsis in the other. In conclusion, the results indicate that further studies are needed to assess the safety of interferon in LT recipients. Interferon-based therapy may lead to acute rejection and subsequent graft loss and should therefore be used with caution. Treated recipients may also develop progressive cirrhosis despite achieving a sustained virological response. (

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