The collection of data which will help define the natural history of the recurrence of hepatitis C (HCV) in patients of liver transplant. Approximately 4000 patients undergo liver transplantation each year in the United States. Cirrhosis (scarring) caused by hepatitis C accounts for approximately 33% of these patients and is the single most common cause of liver transplantation in the U.S. and in other countries. Disease recurrence is prominent and has been observed in 90-95% of patients following transplantation. Fortunately, recurrent HCV is not a rapidly progressing process. The primary goal of this planning grant is to demonstrate if this multi-centered group can gather preliminary data, organize core laboratory facilities, and develop a manual of operations which will be necessary to conduct a definitive multi-centered clinical trial designed to prevent recurrent HCV following liver transplant. The subjects in this study will either require a liver transplant or will have already undergone a transplant. During the patient evaluation for this procedure, patients will undergo a series of tests to help define their operative and post operative risks for survival, to more accurately define the severity of the disease, and the urgency for transplantation. After the surgery, the transplant team will follow the patients on a regular basis. Doses of immunesuppressant medication will be adjusted. Evidence of rejection and recurrence of HCV will be monitored. This study will analyze data on all patients who underwent transplants at the Medical College of Virginia. This will include data regarding the cause of cirrhosis, the severity of cirrhosis, and specific data regarding chronic HCV infection prior to undergoing transplantation. Following transplant, all laboratory data and liver biopsy specimens will be collected. This data will be used to determine if and how chronic HCV contributes to disfunction. All patients who do not have chronic HCV will be used as a control group.
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