Impact of hepatitis C virus (HCV) antiviral treatment on the need for liver transplantation (LT)

2017 ◽  
Vol 38 (6) ◽  
pp. 1022-1027 ◽  
Author(s):  
Esteban Sáez-González ◽  
Carmen Vinaixa ◽  
Fernando San Juan ◽  
Vanesa Hontangas ◽  
Salvador Benlloch ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Antiviral Treatment

scholarly journals Impact of Treatment against Hepatitis C Virus on Overall Survival of Naive Patients with Advanced Liver Disease

2014 ◽  
Vol 59 (2) ◽  
pp. 803-810 ◽  
Author(s):  
Blaise K. Kutala ◽  
Jeremie Guedj ◽  
Tarik Asselah ◽  
Nathalie Boyer ◽  
Feryel Mouri ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Beneficial Effect ◽  
Antiviral Treatment ◽  
Biochemical Response ◽  
Risk Of Death ◽  
Unsuccessful Treatment ◽  
Advanced Liver Fibrosis ◽  
Baseline Characteristics

ABSTRACTThe beneficial effect of achieving a sustained virological response (SVR) after antiviral treatment against hepatitis C virus is well established. However, it remains unclear whether unsuccessful treatment (non-SVR) also improves patient survival, especially in patients with advanced liver fibrosis. We retrospectively evaluated the incidence of death or liver transplantation in the 427 naive patients with a Child-Pugh score of A and advanced fibrosis newly admitted to the Hospital Beaujon between 2000 and 2010. Patients were followed for a median time of 5.5 years. The baseline characteristics of untreated (n= 102) and treated (n= 325) patients were largely similar, and there was no evidence of a bias of indication. Treated patients received a combination of interferon and ribavirin and had an SVR rate of 32%. The incidence of death or liver transplantation per 100 person-years was 1.00, 3.20, and 5.44 in SVR, non-SVR, and untreated patients, respectively. After adjusting for baseline characteristics, the risk of death or liver transplantation was significantly lower in SVR than in non-SVR patients and in non-SVR than in untreated patients (hazard ratios, 0.35 and 0.51, respectively;P= 0.019 and 0.038, respectively). The effect of treatment in non-SVR patients was higher in patients who had a virological or a biochemical response than in those who did not have a virological or a biochemical response. The risk of death or liver transplantation was significantly lower in treated than in untreated patients. Moreover, there was a gradient of mortality between patients with SVRs, virological or biochemical responders, and untreated patients, suggesting that treatment, even in the absence of viral eradication, has a beneficial effect on survival.

scholarly journals Urgent Splenectomy after Partial Splenic Embolization in Liver-Transplanted Patient: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Jorge Herrador Benito ◽  
M. G. Zunzarren ◽  
T. Pozancos de Simón ◽  
L. Tortolero ◽  
R. Latorre Fragua ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Case Report ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Antiviral Treatment ◽  
Splenic Abscess ◽  
Severe Complication ◽  
Partial Splenic Embolization ◽  
Transplant Patients ◽  
Splenic Embolization

We describe a 51-year-old-male. Three months after liver transplantation due to hepatitis C virus (HCV) hepatopathy, an HCV relapse was detected, and partial splenic embolization (PSE) was performed prior to antiviral treatment. Eleven days after PSE emergency splenectomy was performed due to the development of a splenic abscess, which is a rare but severe complication of PSE. Between May 2002 and March 2012, 18 PSEs have been performed in transplant patients in our centre. The patient presented here is the only case of splenic abscess and the only one who has needed surgery after complications of PSE.

scholarly journals Hepatitis C virus recurrence after liver transplantation in Hungary. Trends over the past 10 years

2013 ◽  
Vol 154 (27) ◽  
pp. 1058-1066 ◽  
Author(s):  
Fanni Gelley ◽  
György Gámán ◽  
Zsuzsanna Gerlei ◽  
Gergely Zádori ◽  
Dénes Görög ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Graft Survival ◽  
Patient Survival ◽  
De Novo ◽  
Antiviral Treatment ◽  
Survival Rates ◽  
Early Recurrence ◽  
The Past

Introduction: Management of hepatitis C virus recurrence is a challenge after liver transplantation. Aim: The aim of the authors was to analyse the outcome of liver transplantation performed in hepatitis C virus positive patients during the past ten years and to compare recent data with a previous report of the authors. Method: The authors retrospectively evaluated the data (donors, recipients, perioperative characteristics, patient and graft survival, serum titer of hepatitis C virus RNA, histology) of 409 patients who underwent liver transplantation between 2003 and 2012. Results: 156 patients were transplanted due to hepatitis C virus associated liver cirrhosis (38%). Worse outcome was observed in these patients in comparison to hepatitis C virus negative recipients. The cumulative patient survival rates at 1, 5, and 10 year were 80%, 61%, 51% in the hepatitis C virus positive group and 92%, 85%, 79% in the hepatitis C virus negative group, respectively (p<0.001). The cumulative graft survival rates at 1, 5 and 10 year were 79%, 59% and 50% in hepatitis C virus positive and 89%, 80% and 70% in hepatitis C virus negative patients (p<0.001). Hepatitis C virus recurrence was observed in the majority of the patients (132 patients, 85%), mainly within the first year (83%). The authors observed recurrence within 6 months in 71 patients (56%), and within 3 months in 26 patients (20%). The mean hepatitis C virus recurrence free survival was 243 days. Higher rate of de novo diabetes was detected in case of early recurrence. The cumulative patient survival rates at 1, 3, 5, 10 years were 98%, 89.5%, 81% and 65% when hepatitis C virus recurrence exceeded 3 months and 64%, 53%, 30.5% and 30.5% in patients with early recurrence (p<0.001). Conclusions: Poor outcome of liver transplantation in hepatitis C virus positive patients is still a challenge. Hepatitis C virus recurrence is observed earlier after liver transplantation in comparison with a previous report of the authors. De novo diabetes occurs more frequently in case of early recurrence. Despite an immediate start of antiviral treatment, early recurrence has a significant negative impact on the outcome of transplantation. Orv. Hetil., 2013, 154, 1058–1066.

Liver Support With Albumin Dialysis Reduces Hepatitis C Virus Viremia and Facilitates Antiviral Treatment of Severe Hepatitis C Virus Recurrence After Liver Transplantation

2016 ◽  
Vol 20 (2) ◽  
pp. 189-196 ◽  
Author(s):  
Luis Ibáñez-Samaniego ◽  
María-Vega Catalina ◽  
Diego Rincón ◽  
Oreste Lo Iacono ◽  
Ainhoa Fernández ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Antiviral Treatment ◽  
Albumin Dialysis ◽  
Liver Support ◽  
Severe Hepatitis

scholarly journals Antiviral Treatment for Hepatitis C Virus Infection after Liver Transplantation

2010 ◽  
Vol 2010 ◽  
pp. 1-9
Author(s):  
Yasuhiko Sugawara ◽  
Sumihito Tamura ◽  
Norihiro Kokudo
Keyword(s):  
Liver Transplantation ◽  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Antiviral Treatment ◽  
Significant Proportion ◽  
Sustained Viral Response ◽  
Preemptive Therapy

A significant proportion of patients with chronic hepatitis C virus (HCV) infection develop liver cirrhosis and complications of end-stage liver disease over two to three decades and require liver transplantation, however, reinfection is common and leads to further adverse events under immunosuppression. Pretransplant antiviral or preemptive therapy is limited to mildly decompensated patients due to poor tolerance. The mainstay of management represents directed antiviral therapy after evidence of recurrence of chronic hepatitis C. Combined pegylated interferon and ribavirin therapy is the current standard treatment with sustained viral response rates of 25% to 45%. The rate is lower than that in the immunocompetent population, partly due to the high prevalence of intolerability. To date, there is no general consensus regarding the antiviral treatment modality, timing, or dosing for HCV in patients with advanced liver disease and after liver transplantation. New anti-HCV drugs to delay disease progression or to enhance viral clearance are necessary.

Evolution of hepatitis C virus quasispecies after liver transplantation

2001 ◽  
Vol 120 (5) ◽  
pp. A373-A374
Author(s):  
A LYRA ◽  
X FAN ◽  
S RAMRAKHIANI ◽  
A DIBISCEGLIE
Keyword(s):  
Liver Transplantation ◽  
Hepatitis C Virus ◽  
Hepatitis C
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