Hepatitis C recurrence is not associated with allograft steatosis within the first year after liver transplantation

The natural history of allograft steatosis in hepatitis C (HCV)-infected patients after liver transplantation (LT) is poorly understood. The aim of our study was to determine the relationship of allograft steatosis to HCV recurrence after LT. All patients undergoing LT at our center from March 1998 to December 2001 were included in the study. Explanted liver tissue and liver biopsies performed at 1 week, 4 months, and 12 months were scored for degree of allograft steatosis (0-4), fibrosis (0-6), and modified histological activity index (0-18). One hundred sixty-seven HCV and 235 non-HCV-infected patients (control group) underwent LT. Of these patients, 122 HCV and 154 non-HCV patients had a viable graft at 1 year and were analyzed. Allograft steatosis was present in 40% of HCV patients at 4 months and 36% at 1 year. The incidence of allograft steatosis after LT was similar in HCV-infected and non-HCV-infected patients (P not significant). Age of the donor (P = .041), or higher recipient body mass index (BMI) at the time of LT (P = .015) or at 12 months after LT (P = .041) predicted a higher degree of allograft steatosis at 12 months in the HCV group. Degree of allograft steatosis was not associated with higher fibrosis or necroinflammatory score. In conclusion, there is a similar high incidence of allograft steatosis in HCV and non-HCV-infected patients after LT. A high BMI of the HCV-infected recipient is the best predictor for high degree of allograft steatosis after LT. Allograft steatosis does not predict the severity of HCV recurrence in the first 12 months after LT.