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World J Gastroenterol. Jan 14, 2013; 19(2): 158-160
Published online Jan 14, 2013. doi: 10.3748/wjg.v19.i2.158
Recurrent hepatitis C virus after transplant and the importance of plasma cells on biopsy
Eric R Kallwitz
Eric R Kallwitz, Section of Hepatology, Loyola University Medical Center, Maywood, IL 60153, United States
Author contributions: Kallwitz ER was responsible for the entire content, drafting and editing of the manuscript.
Correspondence to: Eric R Kallwitz, MD, Assistant Professor of Medicine, Section of Hepatology, Loyola University Medical Center, 2160 S First Avenue, Maywood, IL 60153, United States.ekallwitz@lumc.edu
Telephone: +1-708-2162538 Fax: +1-708-2166299
Received: September 19, 2012
Revised: December 14, 2012
Accepted: December 22, 2012
Published online: January 14, 2013
Processing time: 124 Days and 23.6 Hours
Abstract

Hepatitis C virus (HCV) is the leading indication for liver transplantation in the United States. It recurs universally after transplant but the rate of fibrosis and the development of graft failure is variable. Different donor and recipient features have been demonstrated to impact fibrosis. Plasma cell hepatitis, a histologic finding, is one feature associated with poor graft and patient outcomes. The pathogenic mechanism resulting in plasma cell hepatitis is poorly understood, with evidence suggesting a role for both the HCV and the immune system.A recent publication described plasma cell hepatitis in a larger context of immune medicated graft dysfunction in transplant recipients receiving interferon based therapy. This manuscript will highlight the topic of plasma cell hepatitis and provide commentary on the lack of recognition, the data regarding pathophysiologic mechanisms and the potential management options.

Keywords: Hepatitis C virus; Plasma cells; Biopsy; Sustained virological response