Long-term outcome of hepatitis C virus infections acquired after pediatric liver transplantation

Authors

  • Carla Venturi,

    1. Pediatric Surgery and Transplant Unit, Saint Luc University Clinics, Brussels, Belgium
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  • Javier Bueno,

    Corresponding author
    1. Digestive Pediatric Surgery and Transplantation, Valle de Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain
    • Pediatric Liver Transplantation Unit, Valle de Hebron University Hospital, Autonomous University of Barcelona, Paseo Valle de Hebron 119-129, Barcelona, Spain 08035
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    • Telephone: 0034934893246; Fax number: 0034934894460

  • Lluís Castells,

    1. Hepatology Department, Valle de Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain
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  • Jesus Quintero,

    1. Pediatric Liver Transplantation Unit, Valle de Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain
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  • Isabel Casas,

    1. Digestive Pediatric Surgery and Transplantation, Valle de Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain
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  • Helena Allende,

    1. Pathology Department, Valle de Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain
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  • Vicente Martinez-Ibañez,

    1. Pediatric Surgery Department, Valle de Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain
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  • Ramón Charco

    1. Pediatric Surgery and Transplant Unit, Saint Luc University Clinics, Brussels, Belgium
    2. Hepatopancreatobiliary Surgery and Transplant Department, Valle de Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain
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Abstract

The outcomes and characterization of hepatitis C virus (HCV) infections after pediatric liver transplantation (LT) have rarely been reported. We describe our experience with HCV infections after pediatric LT. Ten of 207 children (4.8%) who underwent LT at our institution (1985-2010) developed previously undiagnosed HCV disease. Eight received a liver graft before blood product and donor screening for HCV became available. The mean age at transplantation was 8.9 ± 4.3 years, and the median time from transplantation to the diagnosis of HCV was 15.1 years (range = 0.2-19.7 years). The genotypes were 1 (n = 8), 3 (n = 1), and undetermined (n = 1). At the time of this writing, all the patients were still alive with a mean follow-up of 7.3 ± 5.5 years after the diagnosis of HCV. Five patients did not receive treatment; 2 of these patients achieved spontaneous viral clearance (SVC). Four of the 5 treated patients achieved a sustained virological response, and 3 had an early virological response (EVR). Two of these 4 patients developed chronic rejection while they were on treatment, but this was resolved with a conversion from cyclosporine A to tacrolimus. The remaining patient was continuing treatment and had achieved EVR. In conclusion, despite the limitations of our series, de novo HCV infections after pediatric LT seem to have a slow histological progression. Even with genotype 1, the patients have a good long-term prognosis and respond well to treatment. Nevertheless, chronic rejection during antiviral therapy may develop. In addition, SVC may occur in this population. Liver Transpl, 2011. © 2011 AASLD.

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