Liver transplantationCandidatesThe Long-Term Outcomes of Patients Transplanted Due to Acute Liver Failure With Hepatic Human Herpesvirus-6 Infection
Section snippets
Methods
We have previously found HHV-6B antigens in the explanted livers of most patients (80%, n = 32) with unknown ALF, whereas, the opposite was observed in ALF patients with known cause.14 After transplantation, half of the patients with previous pretransplant HHV-6 infection (9/18) develop recurrences, whereas no post-transplant HHV-6 infection of the liver graft was seen among those without pre-transplant HHV-6.16 The aim of this study was to investigate the long-term (9–14 years) courses of
Results
Half of the patients (9/18) with pretransplant HHV-6 developed a relapse of intrahepatic HHV-6 infection. Two of the HHV-6 recurrence patients also had CMV hepatitis, whereas none of the other patients demonstrated intrahepatic CMV.
During the follow-up of 9 years or more, 1 graft and 2 patients were lost in both HHV-6 recurrence and HHV-6-negative groups. The reasons for graft loss were hepatic arterial thrombosis (patient 9) or portal venous thrombosis (patient 23). In addition, 2 patients
Discussion
An association has been established between HHV-6 and indeterminate ALF.12, 13, 14, 15, 16 However, in our material HHV-6 relapse did not cause liver dysfunction, and failed to exert a significant long-term effect on survival. The actual pathogenic role of HHV-6 in ALF remains suggestive only, as viral reactivation could alternatively be induced by an unknown factor, which leads to ALF with HHV-6 entering the scene after the onset of liver failure. However, HHV-6 infection may impact
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Cited by (0)
This work was supported by the grants from the Sigrid Juselius Foundation (to K.H. and I.L.) and the Helsinki University Central Hospital Funds (EVO) (to I.L.).