No need to discontinue hepatitis C virus therapy at the time of liver transplantation

PloS One
Catarina SkoglundMaria Castedal

Abstract

Direct antiviral agents (DAA) has dramatically improved the therapy outcome of hepatitis C-virus (HCV) infection, both on the waiting-list and post liver transplantation (LT). DAA are generally well-tolerated in patients with mild to moderate liver and kidney failure, but some DAAs are contraindicated in patients with severe dysfunction of these organs. Today there are few studies of peri-LT DAA use and treatment is commonly discontinued at the time of LT. We report here our experience of DAA therapy given continuously in the perioperative LT period in a real-life setting in Sweden. In total 10 patients with HCV-cirrhosis, with or without hepatocellular carcinoma, and a median age of 60.5 years (range, 52-65) were treated with DAAs on the waiting list for LT, and continued in the early postoperative period without any interruption, on the basis of not having reached a full treatment course at the time of LT. Sofosbuvir and a NS5A inhibitor with or without ribavirin, or sofosbuvir and ribavirin only, were given. The distribution of genotypes was genotype 1 and 3, in 4 and 6 patients, respectively. Six of the 10 patients had previously been treated with IFN-based therapy. There were no adverse events leading to premature DAA disc...Continue Reading

References

Jul 27, 2006·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Norah A Terrault, Marina Berenguer
May 23, 2012·Journal of Hepatology·René AdamUNKNOWN European Liver and Intestine Transplant Association (ELITA)
Dec 6, 2012·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Esther V HobsonS Catrin Blank
Nov 12, 2014·The New England Journal of Medicine·Paul Y KwoXavier Forns
Dec 2, 2015·Infectious Diseases·Martin LaggingUNKNOWN Swedish Consensus Group
Mar 2, 2016·Current Opinion in Organ Transplantation·Tianyan Chen, Norah A Terrault
Mar 9, 2017·Scandinavian Journal of Gastroenterology·Maria CastedalOla Weiland
May 4, 2017·Digestive Diseases·David Mutimer
Dec 14, 2017·Journal of Clinical and Experimental Hepatology·Narendra S ChoudharyArvinder S Soin
Feb 11, 2018·Liver International : Official Journal of the International Association for the Study of the Liver·Bruno RocheDidier Samuel

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Citations

Feb 11, 2020·JHEP Reports : Innovation in Hepatology·Elizabeth C VernaRobert S Brown
Dec 5, 2020·International Journal of Nephrology and Renovascular Disease·Khaled ElzorkanyAbdelnaser Abdelaty Gadallah
Mar 4, 2021·Liver International : Official Journal of the International Association for the Study of the Liver·Aleksandra Berkan-KawińskaRobert Flisiak

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Methods Mentioned

BETA
biopsies

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