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Related Concept Videos

Tissue Transplantation01:24

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Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Hepatitis C and liver transplantation.

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Direct-acting antiviral agents (DAAs) offer curative treatment for Hepatitis C virus (HCV) infection, impacting liver transplantation (LT) decisions. Optimal timing for DAA treatment in LT candidates and recipients remains under investigation.

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Area of Science:

  • Hepatology and Transplant Surgery
  • Virology and Infectious Diseases
  • Pharmacology and Therapeutics

Background:

  • Hepatitis C virus (HCV) infection is a primary driver for liver transplantation (LT) in the USA and Europe.
  • HCV recurrence post-LT is nearly universal in viremic recipients.
  • Previous treatments like pegylated-interferon and ribavirin had limited efficacy and applicability.

Purpose of the Study:

  • To review the impact of direct-acting antiviral agents (DAAs) on HCV management in liver transplantation.
  • To discuss optimal timing for DAA treatment initiation in relation to LT (pre-LT, early post-LT, or post-recurrence).
  • To explore the potential of using HCV-positive donors to expand the donor pool.

Main Methods:

  • Review of published data on DAA efficacy and safety in liver transplant recipients and candidates.
  • Analysis of trends in LT wait-listing for HCV-related liver disease.
  • Discussion of clinical considerations for DAA treatment strategies.

Main Results:

  • DAAs have significantly improved curative treatment options for HCV in the transplant population.
  • The use of HCV-positive donors is a potential strategy to increase donor availability.
  • LT wait-listing for HCV with decompensated cirrhosis decreased by 32% in the US during 2014-2015 DAA era.

Conclusions:

  • DAA treatment is highly applicable to patients with decompensated cirrhosis and liver transplant recipients.
  • The advent of DAAs is shifting the landscape of HCV management, potentially reducing LT rates.
  • Further research is needed to determine the optimal timing for DAA therapy in the LT pathway.