Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Tuesday, 10 / 24 / 2017

Articles

Diminishing Use of Liver Biopsy among Liver Transplant Recipients for Hepatitis C

ORIGINAL ARTICLE

Diminishing Use of Liver Biopsy among Liver Transplant Recipients for Hepatitis C

Elizabeth Aby1, Melissa A. Jimenez2, Jonathan F. Grotts1, Vatche Agopian2, Samuel W. French3, Ronald W. Busuttil2 and Sammy Saab*1,2

1Departments of Medicine at the University of California at Los Angeles, Los Angeles, California, USA
2Departments of Surgery at the University of California at Los Angeles, Los Angeles, California, USA
3Departments of Pathology at the University of California at Los Angeles, Los Angeles, California, USA

*Correspondence to: Sammy Saab, Pfleger Liver Institute, UCLA Medical Center, 200 Medical Plaza, Suite 214, Los Angeles, CA 90095, USA. Tel: +1-310-206-6705, Fax: +1-310-206-4197, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2017;5(3):197-202 DOI: 10.14218/JCTH.2016.00073
Received: December 6, 2016 Accepted: April 23, 2017 Published online: May 28, 2017

Abstract

Background and Aims: Hepatitis C virus (HCV) cirrhosis is the leading indication for liver transplantation in the United States and recurrent HCV following liver transplantation is a major cause of allograft loss and mortality. Liver biopsies are commonly used to identify recurrent HCV and determine the need for antiviral therapy. The introduction of direct-acting antiviral agents (DAAs) has changed the management of recurrent HCV infection. This study aimed to describe the role of liver biopsies in liver transplant recipients with HCV after the introduction of DAAs.

Methods: A retrospective analysis was performed looking at the rate of liver biopsies post-liver transplantation for HCV. The analysis included 475 adult liver transplants for hepatitis C performed at the University of California, Los Angeles from January 1, 2006 to October 1, 2015. Patients were divided into two eras, pre- and post-introduction of DAAs on December 1, 2013.

Results: In the era before the introduction of DAAs, the percentage of patients biopsied was significantly higher compared to the era after the introduction of DAAs (56.1% vs. 26.9%, p < 0.001).

Conclusions: The introduction of DAAs has changed the management of liver biopsy following liver transplantation and the management of recurrent HCV. Given that DAAs are well tolerated and have high efficacy, liver biopsies are no longer routinely used to justify the use antiviral therapy following liver transplantation.

Keywords

Hepatitis C, Liver transplantation, Biopsy

 

 

Journal of Clinical and Translational Hepatology 2017 vol. 5, 197-202  Html ] [ PDF Full-text ]

 

© The Authors 2017. This article is published under the terms of the Creative Commons Attribution-Noncommercial (CC BY-NC) License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

 

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