Changes in practice and perception of hepatitis C and liver transplantation: Results of a national survey

Transplant Infectious Disease : an Official Journal of the Transplantation Society
Ashton A ShafferChristine M Durand

Abstract

With new practice guidelines, it is important to understand how liver transplant (LT) centers have incorporated direct-acting antivirals (DAAs) into the management of hepatitis C virus-infected (HCV+) candidates and recipients. To explore how DAAs have affected LT centers' willingness to treat HCV+ candidates and recipients and to use HCV+ donors, we surveyed high volume US LT centers (11/2014-12/2015) regarding practices for HCV+ candidates, recipients, and donors, before vs after DAAs. We used the Scientific Registry of Transplant Recipients to compare centers' number of LTs, HCV+ recipients, and HCV+ donors in the years before (1/1/2012-12/31/2013) and after (1/1/2016-12/31/2017) survey administration. Of 80 centers contacted, 57 (71.3%) responded, representing 69.0% of the total volume of LTs in 2013. After DAAs, most centers increased treating candidates with low (≤15) model for end-stage liver disease (MELD) (85.2%), intermediate/high (>15) MELD (92.6%), and hepatocellular carcinoma (79.6%). There was consensus to treat low MELD candidates (90.8% "most of the time/always"), but less certainty for intermediate/high MELD candidates (48.2% "sometimes"). Universal post-LT HCV treatment increased (7.4% vs 57.4%). After DAAs, 4...Continue Reading

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Citations

Nov 1, 2018·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Allison J KwongPaul Y Kwo
Oct 15, 2019·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Peng-Sheng TingPo-Hung Chen
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Mar 13, 2019·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Mary G BowringDorry L Segev
Dec 19, 2018·Digestive Diseases and Sciences·Akshay ShettySammy Saab
Sep 1, 2021·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Zachary PredmoreAlbert W Wu

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