Prediction of Hepatitis C Recurrence in Liver Transplant Recipients
Prediction of Hepatitis C Recurrence in Liver Transplant Recipients
The purpose of the study is to look at cells of the immune system to see if the cells are
 different among people with different risk factors that have received a liver transplant. We
 will enroll 50 patients receiving liver transplant and their donors. Both donor and recipient
 must participate in the order for the recipient to participate in the study. We will take
 blood samples from these patients and their donors.
To establish whether in-vitro donor-specific immune reactivity patterns can differentiate
 between those liver transplant recipients who are positive for the Hepatitis C virus (HCV)
 who are at high risk and those who are at low risk for graft loss secondary to early
 recurrence of HCV.

 An assessment of the recipient's donor-specific immune status can be achieved by measuring
 T-cell activity, specifically alloreactive primed (donor-specific) T cell activity. It has
 been shown that detection of IFN-y in short-term enzyme-linked-immunosorbent-spot (ELISPOT)
 assay is consistent with the presence of primed memory T cells (6). In the transplantation
 setting, T cells of an allograft recipient that secret IFN-y after short in-vitro exposure to
 donor cells represent a prior sensitization of recipient to donor antigens in vivo.
 Clinically interpreted - this priming event may signify the presence of an up-coming, or an
 on-going, rejection episode. Our limited preliminary data suggest an additional potential
 clinical value for the in-vitro assessment of donor-specific IFN-y production in predicting
 those liver transplant recipients at higher risk for recurrence of Hepatitis C.
Inclusion Criteria:

 -  Patients must be >18 years of age

 -  Chronic HCV infection (and cirrhosis) - group 1

 -  HCV RNA positive pre-transplant - group 1

 -  Liver cirrhosis not due to HCV infection - group 2

 Exclusion Criteria:

 -  All patients < than 18 years of age

 -  Patients with hepatitis C infection

 -  Candidates receiving multi-organ combined transplantation

 -  Patients who have received a previous liver transplantation

 -  Patients who are unable to understand English