University of Virginia Health System

The Transplant Surgery Service and the Charles O. Strickler Transplant Center at the University of Virginia are dedicated to finding new ways to fight liver and kidney disease by improving patient outcomes. The Transplant Program, for example, has made an important breakthrough in protecting transplanted livers in those patients who have chronic hepatitis B. Liver transplant patients frequently experience a recurrence of the viral infection. University of Virginia researchers, however, have discovered that individualized doses of hepatitis B antibody given during and after transplant can stop the recurrence of infection in the transplanted liver. Until now, a transplant for hepatitis B had not been approached by many institutions.

Viral recurrence remains the challenge for the patient population that has had a liver transplant for hepatitis C. Several new drugs, however, are being tested to control the virus before the liver is damaged and retransplantation is required. These drugs are intended to either impede viral replication within the liver or to enhance the immune system's ability to destroy the virus. We are fighting the problem on two fronts: conducting research to identify why the body cannot rid itself of the virus and developing effective viral therapy to keep the liver transplant healthy. Currently, patients who receive a liver transplant are being randomized to either cyclosporine or tacrolimus as the primary immunosuppressive drug to determine if either of these agents has a better outcome in delaying or preventing allograft infection. As part of this project, the virus is being analyzed to detect mutations that may occur in the genetic material. A pharmaceutical company has developed an antibody preparation that has activity against the hepatitis C surface antigens, and the University of Virginia will be the first center to administer the preparation to humans. If found to be safe, medical personnel at the University will administer the drug to patients at the time of transplantation in an attempt to prevent the virus from attacking the transplanted liver.

Researchers in the Department of Surgery and in the Charles O. Strickler Transplant Center are also participating in a number of ongoing drug trials, working closely with referring physicians to improve the quality of life for organ transplant recipients. UVa researchers continue to initiate new trials and participate in investigations that ensure UVa's patients receive the most advanced care available.