Lung Transplant Research Today is a free monthly online journal that collates and summarizes the latest research about Lung Transplant, including details on risks, prognosis, procedure, surgery, organ donation.

Outcomes after lung transplantation in patients with chronic hepatitis C virus infection.

Sahi H, Zein NN, Mehta AC, Blazey HC, Meyer KH, Budev M

Department of Pulmonary, Allergy and Critical Care Medicine, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.

BACKGROUND: Hepatitis C virus (HCV) infects 4 million people in the USA, with a prevalence of 1.4%. The seropositivity rate among potential lung transplant candidates is 1.9%, yet little information is available regarding outcomes of lung transplantation in HCV-positive lung transplant recipients. Our study reports outcomes of lung transplantation in HCV-positive recipients and compares them to HCV-negative controls. METHODS: A retrospective analysis of the Cleveland Clinic Foundation's lung transplant database (465 patients) identified six HCV-positive patients. Demographic data, etiology of HCV infection, HCV viral load pre- and post-transplant, pre-transplant hepatic pathology, serial transaminases, incidence of acute hepatitis, graft function data and patient survival data were obtained by chart extraction. RESULTS: Five HCV-positive recipients had a pre-transplant liver biopsy, none of whom had evidence of cirrhosis pre-transplant. Although HCV RNA levels markedly increased post-transplant, no concomitant increase in transaminases was noted. There was no significant difference in the incidence of acute rejection at 1 year in our HCV-positive cohort compared with the HCV-negative lung transplant recipients from our institution. One patient developed bronchiolitis obliterans syndrome (BOS) during the follow-up period. Two patient deaths occurred, one at 8 months and the other at 2 years post-transplant. No evidence of hepatic dysfunction was noted in either deceased patient. The four surviving patients are alive at a median 3.2 years (range 1 to 6 years). CONCLUSIONS: No significant difference in patient or graft survival was noted between the HCV-positive lung transplant recipients and the HCV-negative recipients.

Published 23 April 2007 in J Heart Lung Transplant, 26(5): 466-71.
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