Management of HCV in the liver transplant setting

Hepatitis C-related cirrhosis is the main indication for liver transplantation. In the absence of viral eradication, viral recurrence leads to recurrent HCV disease and progression to advanced graft disease in many recipients, particularly those transplanted with subobtimal grafts. Viral eradication is associated with improved outcome whether used pre- or post-transplantation. In the new era of interferon-free regimes, this is now safe and feasible in most transplant candidates and transplant recipients. There are questions that remain unanswered, such as defining the point of no return where clinical improvement does not follow viral eradication or management of treatment failures.