Am J Gastroenterol 1992 Apr;87(4):409-18

Liver transplantation for viral hepatitis: current status

Martin P, Munoz SJ, Friedman LS
Department of Medicine, Jefferson Medical College, Philadelphia, Pennsylvania.

Abstract
Liver transplantation is now considered definitive therapy for end-stage liver
disease and has been playing an increasingly important role in the management of
fulminant hepatic failure. With the advent of effective immunosuppression and
improved surgical techniques, high survival rates can be expected for most
transplanted patients. It has become apparent, however, that transplantation for
patients with viral hepatitis is associated with some unique problems because of
the propensity for viral reinfection of the grafted liver. Patients with
actively replicating hepatitis B viral infection pretransplantation appear to be
most likely to experience clinically significant recurrent hepatitis. Recurrent
hepatitis D (delta) and hepatitis C appear to be relatively less serious in the
transplanted liver. Interventions to prevent or treat graft reinfection have
thus far met with limited success. Further studies are needed to define more
precisely which patients with viral hepatitis are likely to do poorly after
liver transplantation, and to develop strategies for treating recurrent
hepatitis in transplant recipients