Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Sunday, 12 / 16 / 2018

Articles

Elimination of Hepatitis C in Liver Transplant Recipients

ORIGINAL ARTICLE

Elimination of Hepatitis C in Liver Transplant Recipients

Sammy Saab*,1,2, Youssef Challita1, Phillip H. Chen2, Melissa A. Jimenez2, Alex D. Lee2, Elena G. Saab2, Timothy Ahn2, Gina Choi1,2, Francisco A. Durazo1,2, Mohamed M. El-Kabany1,2, Steven-Huy B. Han1,2, Jonathan Grotts1, Vatche G. Agopian2 and Ronald W. Busuttil2

1Department of Medicine, University of California at Los Angeles, Los Angeles, California, USA
2Department of Surgery 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 2018;6(3):247-250 DOI: 10.14218/JCTH.2017.00079
Received: December 28, 2017 Accepted: February 26, 2018 Published online: June 8, 2018

Abstract

Background and Aims: Recurrent hepatitis C (HCV) disease in liver transplant (LT) recipients is associated with significant morbidity and mortality. With the availability of noninterferon-based therapy, eliminating HCV may be achievable in LT recipients.

Methods: We studied all consecutive recipients who underwent LT at the University of California Los Angeles between January 2005 and June 2017. We collected data on date of transplant and last follow-up, as well as laboratory values. We also recorded type and timing of antiviral therapy relative to LT. Analyses were performed to assess the proportion of LT recipients who are viremic after transplant.

Results: Six hundred thirty-four patients underwent LT with a diagnosis of HCV. There was a statistically significant trend for patients to be cured before (p < 0.001) and after liver transplantation (p < 0.001) for the study period of 2014 to 2016 relative to 2005 and 2013, respectively. Of the 634 recipients eligible for therapy, 8% and 74% were treated within 12 months of transplant for the study periods 2005 to 2013 and 2014 to 2016, respectively. There was a significant decrease between the two study periods in the proportion of patients undergoing re-LT 1 year after the original LT: 5.5% (n = 28/510) and 1.5% (n = 2/124) respectively for study periods 2005 to 2013 and 2014 to 2016 respectively (p = 0.011).

Conclusions: The proportion of LT recipients who are viremic has decreased over time. Eliminating HCV in LT recipients is feasible after the introduction of direct-acting agents. Curing HCV should translate to improved clinical outcomes in LT recipients who were transplanted for HCV infection with longer follow-up. Preliminary results suggest the decreased need for transplant in the direct-acting agents era.

Keywords

Hepatitis C, Direct-acting agents, Liver transplant, Elimination

 

 

 

Journal of Clinical and Translational Hepatology 2018 vol. 6, 247-250  [ Html ] [ PDF Full-text ]

 

© The Authors 2018. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), 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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