Rapid Onset Fibrosing Cholestatic Hepatitis C Following Transplant of a Hepatitis C Infected Graft Into a Naïve Recipient.

Fibrosing cholestatic hepatitis (FCH) is a devastating complication that can occur when hepatitis C virus (HCV) recurs following liver transplantation. When it occurs, FCH typically develops between 1 and 6 months following transplant and is associated with markedly elevated HCV levels. With the advent of direct-acting antiviral therapy, FCH C is now a rare occurrence. Here, we describe a rare case of early-onset FCH that occurred when an HCV nucleic acid test (NAT) positive liver graft was transplanted into a hepatitis C naïve recipient. This case highlights the importance of initiation of antiviral therapy as soon as possible following transplantation of an HCV NAT-positive liver graft as recommended by current guidelines.