A pleasant dilemma to have: to treat the HCV patient on the waiting list or to treat post-liver transplantation?

Clinical Transplantation
Jonathan E BarsaThomas D Schiano

Abstract

New and relatively well-tolerated medications to treat hepatitis C virus (HCV) infection have presented an opportunity for hepatologists to eliminate HCV in liver transplant (LT) candidates prior to transplantation. While concern for causing decompensated liver disease in the sickest subset of pre-transplant patients makes some clinicians reluctant to offer treatment, we believe that several advantages of early HCV eradication appear to shift the debate in favor of using anti-HCV agents before LT. There are encouraging safety data for new HCV medications in cirrhotic patients, and given the limited supply of donor livers available, delaying or possibly preventing the need for LT by treating HCV can offer significant benefit. Post-LT, making immunosuppression management easier as well as avoiding both extrahepatic manifestations of HCV (e.g., diabetes mellitus and kidney disease) and the dilemma of distinguishing post-transplant viral recurrence from allograft rejection makes earlier treatment of HCV especially appealing to clinicians. Furthermore, retrospective data have demonstrated a mortality benefit among HCV patients who are free of the virus at the time of LT. This article explores arguments for and against treating HCV i...Continue Reading

References

Jul 3, 1998·Liver Transplantation and Surgery : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·S A TagaL D Ferrell
Oct 8, 2004·The New England Journal of Medicine·Yun-Fan LiawUNKNOWN Cirrhosis Asian Lamivudine Multicentre Study Group
Mar 15, 2005·Journal of Hepatology·Gregory T Everson
Jul 22, 2005·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Gary L DavisUNKNOWN Collaborative Antiviral Study Group
Sep 27, 2005·Transplantation Proceedings·S MirabellaM Salizzoni
Dec 1, 2005·Cleveland Clinic Journal of Medicine·Aman Ali, Nizar N Zein
Dec 31, 2005·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Kymberly D S WattTimothy M McCashland
Aug 26, 2006·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Thomas D SchianoJohn Andrews
Dec 22, 2007·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Jean-Charles Duclos-ValléeUNKNOWN THEVIC Study Group
Jul 3, 2008·Gastroenterology·Sarah MaylinPatrick Marcellin
Feb 12, 2009·Transplant International : Official Journal of the European Society for Organ Transplantation·Tao ChenHaoming Tian
Sep 1, 2009·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Pratima SharmaAnna S Lok
Jan 26, 2010·Transplantation·Jin-Yon KimGraciela de Boccardo
Oct 30, 2010·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Tarun K NarangMark W Russo
Sep 3, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·P SharmaR M Merion
Jan 25, 2012·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Roberta D'AmbrosioPierre Bedossa
May 23, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Juan BerenguerUNKNOWN GESIDA HIV/HCV Cohort Study Group
Dec 27, 2012·JAMA : the Journal of the American Medical Association·Adriaan J van der MeerHarry L A Janssen
Apr 26, 2013·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Soo AlemanRolf Hultcrantz
Jun 19, 2013·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Josh Levitsky
Mar 25, 2014·World Journal of Gastroenterology : WJG·Francesco VasuriAntonia D'Errico-Grigioni
Mar 29, 2014·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Norah A TerraultUNKNOWN A2ALL Study Group
May 6, 2014·The New England Journal of Medicine·Stefan ZeuzemUNKNOWN VALENCE Investigators
Jul 7, 2014·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Adriano M PellicelliMario Angelico
Jul 20, 2014·JAMA : the Journal of the American Medical Association·Mark S SulkowskiUNKNOWN PHOTON-1 Investigators
Nov 12, 2014·The New England Journal of Medicine·Paul Y KwoXavier Forns
Jan 22, 2015·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Jennifer C Price, Norah A Terrault
Feb 24, 2015·JAMA : the Journal of the American Medical Association·Anu OsinusiShyam Kottilil
Feb 28, 2015·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Surakit PungpapongAndrew P Keaveny
Mar 31, 2015·Transplant International : Official Journal of the European Society for Organ Transplantation·Brett E FortuneGregory T Everson
Apr 8, 2015·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·K Rajender ReddyNezam Afdhal

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Citations

Sep 20, 2016·Journal of Hepatology·Adriaan J van der Meer, Marina Berenguer
Nov 15, 2017·Liver International : Official Journal of the International Association for the Study of the Liver·Karin KozbialPeter Ferenci
Mar 20, 2020·Clinical and Molecular Hepatology·Chung-Feng Huang, Ming-Lung Yu
Mar 4, 2017·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Aijaz AhmedZobair M Younossi
Feb 19, 2019·Canadian Journal of Gastroenterology & Hepatology·Juliet A EmamaulleeNorman Kneteman

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