Hepatitis D virus and liver transplantation: Indications and outcomes

Area of Science:

• Hepatology
• Virology
• Transplant Surgery

Background:

• Hepatitis D virus (HDV) is an obligate parasite dependent on hepatitis B virus (HBV) for replication and transmission.
• Chronic HDV infection leads to severe liver disease, including end-stage liver disease and hepatocellular carcinoma.
• Current treatments like pegylated interferon alpha have limited efficacy and significant side effects.

Purpose of the Study:

• To review the indications and outcomes of liver transplantation (LT) for patients with HDV infection.
• To discuss current and emerging treatment options for chronic HDV.

Main Methods:

• Review of international data and literature on liver transplantation for HDV and HBV coinfection.
• Analysis of treatment strategies and outcomes in patients undergoing LT for HDV.

Main Results:

• Liver transplantation is the definitive treatment for end-stage liver disease, hepatocellular carcinoma, or fulminant hepatitis in HDV-HBV coinfected patients.
• International centers provide most of the long-term data on LT outcomes in this population due to its rarity in the US.
• Discussion of various treatment modalities in conjunction with LT.

Conclusions:

• Liver transplantation offers a life-saving option for patients with advanced HDV-related liver disease.
• Further research and data collection, particularly from US centers, are needed to optimize LT protocols and post-transplant management for HDV patients.