A systematic review of direct acting antiviral therapies in hepatitis C virus‐negative liver transplant recipients of hepatitis C‐viremic donors

Snyder, Heather; Wiegel, Joshua J; Khalil, Karen; Summers, Bryant B; Tan, Teresa; Jonchhe, Srijana; Kaiser, Tiffany E.

doi:10.1002/phar.2742

Cited by 4 publications

(2 citation statements)

References 46 publications

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“…Further optimization of hepatitis virus-positive liver utilization is needed to improve the access of all LT recipients. [157]. Furthermore, another research compared the difference between HCV+ HCV-grafts in HCV+ recipients, finding that donor hepatitis C status didn't impact on graft or patient survival after LT for HCV+ recipients [158].…”

Section: Hepatitis Virus-positive Liver Grafts 61 Definitionmentioning

confidence: 99%

Current Understanding of Marginal Grafts in Liver Transplantation

Xiang,

Li,

Zeng

et al. 2024

Aging and disease

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End-stage liver disease (ESLD), stemming from a spectrum of chronic liver pathologies including chronic liver failure, acute cirrhosis decompensation and hepatocellular carcinoma, imposes a significant global healthcare burden. Liver transplantation (LT) remains the only treatment for ESLD. However, the escalating mortality on transplant waitlists has prompted the utilization of marginal liver grafts in LT procedures. These grafts primarily encompass elderly livers, steatotic livers, livers from donation after circulatory death, split livers and those infected with the hepatitis virus. While the expansion of the donor pool offers promise, it also introduces concomitant risks. These encompass graft failure, biliary and cardiovascular complications, the recurrence of liver disease and reduced patient and graft survival. Consequently, various established strategies, ranging from improved donorrecipient matching to surgical interventions, have emerged to mitigate these risks. This article undertakes a comprehensive assessment of the current landscape, evaluating the viability of diverse marginal liver grafts. Additionally, it synthesizes approaches aimed at enhancing the quality of such marginal liver grafts. The overarching objective is to augment the donor pool and ameliorate the risk factors associated with the shortage of liver grafts.

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Section: Hepatitis Virus-positive Liver Grafts 61 Definitionmentioning

confidence: 99%

Current Understanding of Marginal Grafts in Liver Transplantation

Xiang,

Li,

Zeng

et al. 2024

Aging and disease

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“…As with kidneys, both HCVþ livers and hearts are increasingly transplanted into HCV-recipients with excellent short-term outcomes [91][92][93][94]; long-term survival requires further study. Among HCVþ liver donors, a recent registry analysis found evidence of underutilization, despite excellent 1-year graft survival [95 & ].…”

Section: Other Viremic or Elevated Disease Transmission Risk Donorsmentioning

confidence: 99%

Beyond donation to organ utilization in the USA

Stewart

Lonze

2023

Current Opinion in Organ Transplantation

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Purpose of reviewThe deceased donor organ pool has broadened beyond young, otherwise healthy head trauma victims. But an abundance of donated organs only benefits patients if they are accepted, expeditiously transported and actually transplanted. This review focuses on postdonation challenges and opportunities to increase the number of transplants through improved organ utilization. Recent findingsWe build upon recently proposed changes in terminology for measuring organ utilization. Among organs recovered for transplant, the nonuse rate (NUR REC ) has risen above 25% for kidneys and pancreata. Among donors, the nonuse rate (NUR DON ) has risen to 40% for livers and exceeds 70% for thoracic organs. Programme-level variation in offer acceptance rates vastly exceeds variation in the traditional, 1-year survival benchmark. Key opportunities to boost utilization include donation after circulatory death and hepatitis C virus (HCV)þ organs; acute kidney injury and suboptimal biopsy kidneys; older and steatotic livers.

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Comprehensive review of the application of MP and the potential for graft modification

Vargas

Goldaracena

2023

Front. Transplant.

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IntroductionFollowing procurement, the liver graft is exposed to an ischemic period that triggers several pathophysiologic changes in response to oxygen deprivation. Therefore, the goal during organ preservation is to attenuate such response and provide an adequate environment that prepares the graft for its metabolic reactivation following implantation. This has been widely achieved via static cold storage preservation, where the maintenance of the graft using cold preservation solutions reduce its metabolic activity and confer cytoprotection until transplantation. However, despite being the gold standard for organ preservation, static cold storage holds several disadvantages. In addition, the ongoing organ shortage has led to the use of unconventional grafts that could benefit from therapies pre-transplant. Organ preservation via machine perfusion systems appears as a promising solution to address both.MethodsHere, we aim to present a state-of-the-art narrative review regarding liver graft modification options using machine perfusion systems in combination with adjuvant strategies including immunomodulation, gene therapy and pharmacotherapy.ResultsAvailable reports are scarce and mostly on experimental animal models. Most of the literature reflects the use of normothermic or subnormothermic machine perfusion devices given that these particular type of machine allows for a metabolically active organ, and therefore facilitates its modification. Although limited, promising findings in available reports suggest that organ preservation using machine perfusion system when combined with alternative therapies can be feasible and safe strategies for graft modification.DiscussionFurther research on clinical settings are needed to better elucidate the true effect of graft modification pre-transplant on short- and long-term graft and patient survival. There is a long way ahead to develop guidelines and approve these novel therapies for clinical practice. However, the path looks promising.

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A systematic review of direct acting antiviral therapies in hepatitis C virus‐negative liver transplant recipients of hepatitis C‐viremic donors

Cited by 4 publications

References 46 publications

Current Understanding of Marginal Grafts in Liver Transplantation

Current Understanding of Marginal Grafts in Liver Transplantation

Beyond donation to organ utilization in the USA

Comprehensive review of the application of MP and the potential for graft modification

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