OJGas  Vol.3 No.7 , November 2013
Post-transplant plasma cell hepatitis in a liver transplant patient treated with pegylated interferon plus ribavirin
ABSTRACT

The recurrence of hepatitis C after a liver transplant remains an important cause of graft loss and retransplant. Antiviral therapy with peginterferon plus ribavirin (PEG-INF/RBV) can achieve a sustained viral response and histological improvement in a high percentage of cases. However, this treatment is not exempt from important side effects or from the possibility of precipitating rejection, with the resulting graft loss. We report the case of a liver transplant patient who received treatment with PEG-INF/RBV and developed plasma cell hepatitis as the presenting form of rejection.

 


Cite this paper
Jiménez-Pérez, M. , Rando-Muñoz, F. , González-Grande, R. , Tamargo, F. , de la Cruz Lombardo, J. , López, J. and González, R. (2013) Post-transplant plasma cell hepatitis in a liver transplant patient treated with pegylated interferon plus ribavirin. Open Journal of Gastroenterology, 3, 307-310. doi: 10.4236/ojgas.2013.37053.
References
[1]   Berenguer, M. (2008) Systematic review of the treatment of established recurrent hepatitis C with pegylated interferon in combination with ribavirin. Journal of Hepatology, 49, 274-287.
http://dx.doi.org/10.1016/j.jhep.2008.05.002

[2]   Rubín, A., Aguilera, V. and Berenguer, M. (2011) Liver transplantation and hepatitis C. Clinics and Research in Hepatology and Gastroenterology, 35, 805-812.
http://dx.doi.org/10.1016/j.clinre.2011.04.009

[3]   Hassan, Q., Roche, B., Buffet, C., Bessede, T., Samuel, D., Charpentier, B. and Durrbach, A. (2012) Liver-kidney recipients with chronic viral hepatitis C treated with interferon-alpha. Transplant International, 25, 941-947.
http://dx.doi.org/10.1111/j.1432-2277.2012.01520.x

[4]   Burra, P., Targhetta, S., Pevere, S., Boninsegna, S., Guido, M., Canova, D., Brolese, A., et al. (2006) Antiviral therapy for hepatitis C virus recurrence following liver transplantation: Long-term results from a single center experience. Transplantation Proceedings, 38, 1127-1130.
http://dx.doi.org/10.1016/j.transproceed.2006.02.135

[5]   Levitsky, J., Fiel, M.I., Norvell, J.P., Wang, E., Watt, K.D., Curry, M.P., Tewani, S., et al. (2012) Risk for immune-mediated graft dysfunction in liver transplant recipients with recurrent HCV infection treated with pegylated interferon. Gastroenterology, 142, 1132-1139.
http://dx.doi.org/10.1053/j.gastro.2012.01.030

[6]   Belli, L.S., Volpes, R., Graziadei, I., Fagiouli, S., Starkel, P., Burra, P., Alberti, A.B., et al. (2012) Antiviral therapy and fibrosis progression in patients with mild-moderate hepatitis C recurrence after liver transplantation. A randomized controlled study. Digestive and Liver Disease, 44, 603-609. http://dx.doi.org/10.1016/j.dld.2012.01.017

[7]   Berardi, S., Lodato, F., Gramenzi, A., D’Errico, A., Lenzi, M., Bontadini, A., Morelli, M.C., et al. (2007) High incidence of allograft dysfunction in liver transplanted patients treated with pegylated-interferon alpha-2b and ribavirin for hepatitis C recurrence: Posible de novo autoinmune hepatitis? Gut, 56, 237-242.
http://dx.doi.org/10.1136/gut.2006.092064

[8]   Fiel, M.I. and Schiano, T.D. (2012) Plasma cell hepatitis (de-novo autoinmune hepatitis) developing post liver transplantation. Current Opinion in Organ Transplantation, 17, 287-292.
http://dx.doi.org/10.1097/MOT.0b013e3283536622

[9]   Czaja, A. (2008) Performance parameters of the diagnostic scoring systems for autoimmune hepatitis. Hepatology, 48, 1540-1548. http://dx.doi.org/10.1002/hep.22513

[10]   Fiel, M.I., Agarwal, K., Stanca, C., Elhajj, N., Kontorinis, N., Thung, S.N., Schiano, T.D., et al. (2008) Posttransplant plasma cell hepatitis (de novo autoinmune hepatitis) is a variant of rejection and may lead to a negative outcome in patients with hepatitis C virus. Liver Transplantation, 14, 861-871. http://dx.doi.org/10.1002/lt.21447

[11]   Demetris, A.J. and Sebagh, M. (2008) Plasma cell hepatitis in liver allografts: Variant of rejection or autoimmune hepatitis? Liver Transplantation, 14, 750-755.
http://dx.doi.org/10.1002/lt.21518

[12]   Czaja, A.J. (2012) Diagnosis, pathogenesis, and treatment of autoinmune hepatitis after liver transplantation. Digestive Diseases and Sciences, 57, 2248-2266.
http://dx.doi.org/10.1007/s10620-012-2179-3

 
 
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