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Role of adult living donor liver transplantation in patients with hepatitis C
Author(s) -
Everson Gregory T.,
Trotter James
Publication year - 2003
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1053/jlts.2003.50224
Subject(s) - medicine , liver transplantation , hepatitis c , liver disease , hepatitis , transplantation , cadaveric spasm , gastroenterology , liver regeneration , viral hepatitis , surgery , regeneration (biology) , biology , microbiology and biotechnology
Key points 1. Living donor liver transplantation (LDLT) is an option for patients with end‐stage liver disease or hepatoma caused by chronic hepatitis C. 2. Reports from some, but not all, transplant centers indicate that hepatitis C may recur earlier, recurrence may be more severe, and graft loss caused by recurrent hepatitis C may be more frequent in LDLT compared with cadaveric transplantation. 3. Several unique characteristics of LDLT (versus cadaveric transplantation) may favor severe recurrence of hepatitis C. These include an increase in genetic similarity between donor and recipient, higher degree of HLA matching, greater systemic bioavailability of immunosuppressive agent, and hepatic regeneration. 4. Hepatic regeneration may promote the acceleration and severity of recurrent hepatitis C by enhancement of hepatitis C viral uptake by hepatocytes through stimulation of the low‐density lipoprotein receptor and increase in activity of the internal ribosomal entry site.