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Hepatitis C: liver transplantation.
Julius Metts1, Lesley Carmichael2, Winfred Kokor3
1California Substance Abuse and Treatment Center, 900 Quebec Ave, Corcoran, CA 93212.
FP Essentials
|December 6, 2014
Summary
Hepatitis C virus (HCV) is a leading cause of liver transplants in the US. Post-transplant care involves managing complications like infection, rejection, and long-term health issues related to immunosuppression.
Area of Science:
- Hepatology
- Transplant Surgery
- Immunology
Background:
- Hepatitis C virus (HCV)-related cirrhosis and hepatocellular carcinoma are primary indications for adult liver transplantation in the US, accounting for 40% of procedures.
- Liver transplant survival rates range from 76-83% at 2 years and 69-72% at 5 years.
Purpose of the Study:
- To outline the criteria and considerations for liver transplantation in HCV-infected patients.
- To detail common complications and long-term health issues following liver transplantation.
- To define the role of family physicians in managing post-transplant recipients.
Main Methods:
- Review of current practices and outcomes for liver transplantation in HCV patients.
- Identification of eligibility criteria, including substance abuse history and MELD score.
- Analysis of post-transplant complications and associated medical conditions.
Main Results:
- HCV patients with decompensated liver disease or hepatocellular carcinoma are candidates if eligible for surgery.
- Abstinence from substance abuse for at least 6 months is typically required.
- Common complications include HCV recurrence, organ rejection, infections, diabetes, hypertension, hyperlipidemia, renal dysfunction, osteopenia, and secondary cancers.
Conclusions:
- Liver transplantation is a viable option for select HCV patients, but requires careful management of post-operative complications.
- Long-term health issues, often linked to immunosuppressive therapy, necessitate vigilant monitoring by healthcare providers.
- Family physicians play a crucial role in the ongoing care and management of liver transplant recipients.
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