Intra portal donor specific antigen transfusion might prevent re-infection of hepatitis C virus after living related liver transplantation in hepatitis C hepatic cirrhosis.

Background/Aims: Re-infection of hepatitis C virus (HCV) is very important for prognosis after liver transplantation of HCV cirrhosis. In the mechanism of re-infection of HCV, the peri-transplant immunity including the immunosuppression must be very important for getting the solution of prevention of its infection. (please rewrite this phrase). In this study, we investigated the influences of intraportal DST for HCV-reinfection after living related liver transplantation (LRLT). Methodology: The 12 patients, who underwent LRLT for the end-stage HCV liver cirrhosis from 1999 to 2007 in our hospital, were estimated about the influence of intraportal DST for re-infection of HCV The nine persons of all patients had received the intraportal DST after LRLT. Results: These nine patients could be steroid withdrawn within 2 months. The seven persons of all patients that received intraportal DST were treated with perioperative IFN therapy. Two patients had preoperative interferon-beta therapy. The one patient could obtain SVR. The other patient dropped out for the complications. The four patients had interferon-alpha therapy in the acute hepatitis phase. Two patients had it in the chronic hepatitis phase. The one patient mentioned before, had preoperative IFN-beta and dropped out. HCV of the one patients without interferon therapy disappeared spontaneously from 3 months. The HCV disappeared in the 6 patients (66.7%) of all nine patients with intraportal DST after LRLT. The five of six patients were SVR. The patient who got preoperative IFN-beta revealed the macrochimerism of donor type CD56+T cell in the graft liver one month after LRLT. The immunological analysis about the patient, who got a spontaneous disappearance of HCV two months after LRLT, demonstrated that CD56+T cells strongly developed the both FasL and TRAIL expressions. Conclusion: In this study, the clinical and immunological findings suggested that intraportal DST might affect for the clearance of HCV by the both host immunity and IFN-ribavirin therapy.