Treatment strategies for patients with decompensated liver cirrhosis due to hepatitis C virus infection eligible for liver transplantation: real-life data from five German transplant centers

European Journal of Gastroenterology & Hepatology
Lisa SandmannThomas von Hahn

Abstract

Even with highly effective direct-acting antivirals (DAAs) treatment of patients with decompensated hepatitis C (HCV) cirrhosis remains challenging. Clinical deterioration and the need for liver transplantation (LT) may arise despite previous antiviral treatment. It is unclear whether in patients with high Model for End-Stage Liver Disease (MELD) antiviral treatment is too risky and should thus be deferred until after LT. Treatment choices that are currently made in the real-world setting are unclear. We performed a retrospective multicenter data analysis of patients with decompensated HCV cirrhosis (MELD ≥15) that presented to liver transplant centers that are part of the German Center for Infection Research when highly active DAA therapy was available. Choice of treatment strategy (DAA first vs. transplantation first) was analyzed and correlated with baseline and outcome parameters. Thirty-five patients fulfilled the inclusion criteria and their mean MELD score was 18.5±3.78 (median: 17, interquartile range=16-19). In the majority of patients (85.7%) DAA therapy was initiated before LT; survival rates and change in MELD were numerically better in this group compared with those where DAA therapy was withheld (82.1 vs. 40%, P=0...Continue Reading

References

Nov 11, 2009·Medical Microbiology and Immunology·Jan Peveling-OberhagWolf Peter Hofmann
Dec 27, 2012·JAMA : the Journal of the American Medical Association·Adriaan J van der MeerHarry L A Janssen
Apr 15, 2014·The New England Journal of Medicine·Nezam AfdhalUNKNOWN ION-2 Investigators
Apr 15, 2014·The New England Journal of Medicine·Nezam AfdhalUNKNOWN ION-1 Investigators
Nov 12, 2014·The New England Journal of Medicine·Paul Y KwoXavier Forns
May 20, 2015·Gastroenterology·Michael CharltonUNKNOWN SOLAR-1 Investigators
Sep 2, 2015·Journal of Hepatology·Jessica K DysonStuart McPherson
Nov 17, 2015·The New England Journal of Medicine·Michael P CurryUNKNOWN ASTRAL-4 Investigators
Nov 17, 2015·The New England Journal of Medicine·Jordan J FeldUNKNOWN ASTRAL-1 Investigators
Nov 18, 2015·The New England Journal of Medicine·Graham R FosterUNKNOWN ASTRAL-3 Investigators
Dec 15, 2015·Journal of Hepatology·Martin-Walter WelkerChristoph Sarrazin
Dec 15, 2015·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Andres F CarrionNorman L Sussman
Dec 26, 2015·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Eric LawitzJames Witek
Jan 13, 2016·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Fred PoordadEugene S Swenson
Feb 2, 2016·Journal of Hepatology·Graham R FosterUNKNOWN HCV Research, UK
May 24, 2016·Journal of Hepatology·Luca Saverio BelliUNKNOWN European Liver and Intestine Association (ELITA)
Dec 3, 2016·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Jagpreet ChhatwalRaymond T Chung
Mar 23, 2017·Journal of Hepatology·Luca S BelliMario Strazzabosco
Aug 27, 2017·Journal of Hepatology·Juan Manuel PascasioMaría-Carlota Londoño
Jan 3, 2018·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·W R KimB L Kasiske
Jan 25, 2018·The New England Journal of Medicine·Stefan ZeuzemFederico J Mensa
Feb 7, 2018·Journal of Viral Hepatitis·P A CortesiUNKNOWN European Liver and Intestine Transplant Association (ELITA)
Apr 14, 2018·Journal of Hepatology·UNKNOWN European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu, UNKNOWN European Association for the Study of the Liver

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Citations

Mar 4, 2021·Liver International : Official Journal of the International Association for the Study of the Liver·Aleksandra Berkan-KawińskaRobert Flisiak
Aug 2, 2019·Visceral Medicine·Lisa SandmannBenjamin Maasoumy

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