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Hepatitis C virus and liver transplantation
1Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Liver Transplant Program, Stanford University Medical Center, Stanford, California, USA.
Clinics in Liver Disease
|November 1, 2001
Summary
Liver transplantation survival is improving, but recurrent hepatitis C (HCV) remains a challenge. Combination antiviral therapy shows promise for treating post-transplant HCV, improving patient outcomes and quality of life.
Area of Science:
- Hepatology
- Transplantation Immunology
- Virology
Background:
- Liver transplantation offers improved survival for chronic viral hepatitis.
- Hepatitis C virus (HCV) recurrence is common post-transplant, unlike hepatitis B.
- No definitive prevention for recurrent HCV exists, impacting long-term outcomes.
Purpose of the Study:
- To review outcomes of liver transplantation for chronic HCV.
- To evaluate treatment strategies for recurrent HCV post-transplantation.
- To assess the impact of recurrent HCV on patient quality of life.
Main Methods:
- Review of current literature on liver transplantation for HCV.
- Analysis of factors influencing HCV recurrence and allograft injury.
- Evaluation of antiviral therapies for post-transplant HCV.
Main Results:
- Long-term survival after liver transplantation for HCV is uncertain.
- Recurrent HCV can range from mild to severe allograft injury.
- Combination therapy (interferon/ribavirin) shows promise for recurrent HCV.
- Recurrent HCV negatively impacts quality of life and mental health.
Conclusions:
- Pegylated interferon plus ribavirin is a promising treatment for recurrent HCV.
- Antiviral therapy is recommended for moderate to severe allograft hepatitis.
- Improved antiviral therapies may reduce the need for liver transplantation.
- Donor pool expansion strategies can benefit HCV patients awaiting transplant.