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MINERVA GASTROENTEROLOGICA E DIETOLOGICA

A Journal on Gastroenterology, Nutrition and Dietetics


Indexed/Abstracted in: CAB, EMBASE, PubMed/MEDLINE, Scopus, Emerging Sources Citation Index


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REVIEW  LIVER TRANSPLANTATION: INDICATIONS AND OUTCOMES


Minerva Gastroenterologica e Dietologica 2018 June;64(2):158-69

DOI: 10.23736/S1121-421X.17.02448-5

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Hepatitis C and liver transplantation

Silvia MARTINI

Unit of Gastrohepatology, AOU Città della Salute e della Scienza di Torino, Turin, Italy


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Hepatitis C virus (HCV)-related liver disease represents the leading indication for liver transplantation (LT) in the USA and Europe and HCV recurrence is universal in recipients who are viremic at LT. Until a few years ago, pegylated-interferon in association with ribavirin was the only therapeutic strategy, usable only in compensated cirrhotic patients, in order to prevent post-LT viral recurrence. The recent advent of direct-acting antiviral agents (DAAs) has dramatically increased the chances of curative treatment for the transplant population and the debate about which should be the best time for treating the infection is still open: whether to pursue HCV eradication 1) before LT, in order to improve liver function, delist some patients and prevent graft infection; or 2) as early as possible after LT, rather than 3) waiting for hepatitis C recurrence before starting treatment. In addition, in the DAA era, the use of HCV-positive donors may represent a potential approach to safely expanding the donor pool. As more HCV patients achieve cure with DAA regimens, the LT trend for HCV in the future would be expected to mimic the trend observed for hepatitis B virus in the past decade and in the United States, during the DAA-period 2014-2015, the rate of LT wait-listing for HCV complicated by decompensated cirrhosis has already decreased by 32%. This review summarizes the published data and emphasizes DAA treatment applicability to patients with decompensated cirrhosis and to liver transplant recipients.


KEY WORDS: Hepacivirus - Liver transplantation - Tissue donors

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Publication History

Issue published online: March 30, 2018
Article first published online: September 25, 2017
Manuscript accepted: September 21, 2017
Manuscript received: September 17, 2017

Cite this article as

Martini S. Hepatitis C and liver transplantation. Minerva Gastroenterol Dietol 2018;64:158-69. DOI: 10.23736/S1121-421X.17.02448-5

Corresponding author e-mail

smartini@cittadellasalute.to.it