Prophylactic alpha-interferon therapy following liver transplantation: does it prevent allograft infection?

Objective To assess the efficacy and safety of prophylactic alpha-interfection therapy in liver allograft recipients. Patients An open-label consecutive series of liver transplant recipients who underwent surgery for chronic hepatitis B virus (HBV) and C virus (HCVJ disease. Interventions: Alpha-interferon, 5MU three times weekly, was administered to 16 liver allograft recipients, beginning 3 weeks after transplantation for a total of 6 months or more. Main outcome measures Clearance of hepatitis B surface antigen (HBsAg) or HCV-RNA from blood, liver histology and standard measures of liver biochemistry. Results Of the patients with HBV-related disease, seven out of eight remained HBsAg-negative despite discontinuing anti-HBV hyperimmune gammaglobulim therapy. None of the patients with HCV disease became HCV-RNA-negative. All experienced progression in their hepatitis activity index (Knodell) score. Only two episodes of liver allograft rejection were observed, both of which were easily treated with additional immunosuppression. Conclusions Prophylactic interferon therapy can be administered to liver allograft recipients for the prevention of recurrent HBV infection. At a dose of 5MU three times weekly, alpha-interferon enhanced HBsAg clearance, but failed to clear HCV-RNA.