Rapidly Progressing Cholestatic Liver Failure After Allogeneic Stem Cell Transplant from Hepatitis C Virus-Positive Donor (FCHCV)

There are several different liver disorders which may occur concurrently post-HSCT. This chapter covers the history of hepatitis C virus (HCV) before the development of direct-acting antiviral therapy. The case discusses an HCV-negative patient who received a transplant from his HCV-positive donor. The patient had well-established hepatic GVHD but later developed a rapid rise in his aminotransferases coupled with a rapid rise in his HCV viral copy number. The pathology of fibrosing cholestatic hepatitis (FCH) is described and compared with the pathologic features typical of hepatic GVHD. The differential diagnoses of rapidly rising posttransplant liver tests are discussed.