Morphological features and differential diagnosis of hepatitis C recurrence after liver transplantation - literature review and results of single transplantation center.

Orthotopic liver transplantation (OLT) is an established method of treatment for advanced and irreversible liver diseases. Type C (HCV) viral hepatitis is the most common indication for OLT in Western Europe, USA, and also in Poland. Recurrence of primary disease, that led to OLT, constitutes the crucial problem in medical care of transplanted patients. HCV recurrence is nearly universal, but the course of reinfection is unpredictable. There are many risk factors predisposing to more severe liver disease, related to characteristics of donor, recipient and virus. It was noted, that the course of HCV reinfection was more aggressive in patients transplanted in recent years. Generally, chronic HCV infection develops more aggressively in the liver allograft compared to the native liver and leads more rapidly to liver cirrhosis and graft failure. There are no certain laboratory tests or imaging techniques reflecting the status of infected liver. Morphological examination of liver biopsies is still essential to assess actual organ status, the activity and progression of the inflammatory process and the presence of other posttransplant complications. Results concerning the course of HCV reinfection are equivocal and differ in various populations. Many unresolved issues still remain. In the presented study pathomorphological features of HCV reinfection, differential diagnosis, and the basic results of authors' investigations concerning the relationship between many clinical and histopathological data and aggressiveness of HCV reinfection are described.