Early
mortality due to
hepatitis C virus (HCV)-related
liver failure in renal
allograft recipients in the absence of fibrosing cholestatic
hepatitis is reported infrequently. We
report six renal
allograft recipients with HCV
infection who died of rapid progression to
liver failure. Of these, 2 were detected anti-HCV positive at
screening prior to
kidney transplantation and 4 were diagnosed after
transplantation following derangement of
liver function (HCV
RNA positive in all 4, anti-HCV positive in 2). Median interval between
kidney transplantation and derangement of
liver function was 11.8 months (range 2 to 25) and median interval between
transplant and
death was 27 months (range 11 to 53).
Liver biopsy performed during the terminal illness in 3
patients and post-mortem
liver histology in 2
patients showed
chronic hepatitis with mean grade of 10.2 (range 9 to 12) and stage 2.4 (range 2 to 3). None had features of fibrosing cholestatic
hepatitis.