Retrospective study of the outcome of liver transplantation in Egyptian patients with chronic hepatitis C virus infection

Aim
To assess the outcome of living-related-donor liver transplantation for chronic hepatitis C infection in Egyptian patients including hepatitis C recurrence, fibrosis progression, and improved survival.


Patients and methods
This retrospective study included 104 adult Egyptian patients with chronic liver disease due to chronic hepatitis C, who underwent living-donor liver transplantation at Wadi El-Neel Hospital, Cairo, Egypt, during the period from January 2005 to January 2014. All data regarding comprehensive history taking, clinical examination, laboratory evaluation, model for end-stage liver disease score, fibrosis-4 score, liver biopsy, histopathology examination, and radiological evaluation before and after transplant were collected and analyzed. Moreover, the data of regimen of immunosuppression and regimen of antiviral therapy after transplant were collected and analyzed.


Results
There were 75 males and 29 females. Their ages ranged from 30 to 74 years, with an average of 51.62 years old. Of 104 cases, 90 were of class C, whereas 13 cases of class B, and only one case was class A Pugh–Child classification. Of 104 cases, 31 missed follow-up owing to follow-up in another hospital within their city. Recurrence of hepatitis C virus infection after liver transplantation occurred in 73 (70.19%) cases. Sustained virological response was observed in 40 (54.79%) cases, and relapse was observed in 33 (31.73%) cases after antiviral treatment. Second relapse after treatment occurred in 33 (31.73%) of 73 cases and received antiviral therapy course again, with sustained virological response in 15 (45.45%) cases out of 33, relapse again was seen in seven (21.21%) of 33 cases, and 11 (42.4%) of 33 cases were nonresponders. According to clinical outcomes in the studied cases, eight (7.7%) died, five (4.8%) cases had decompensated liver disease, five (4.8%) cases underwent retransplantation, two (19%) cases had liver fibrosis, and one case (0.96%) had hepatocellular carcinoma.