Hepatitis C impairs survival following liver transplantation irrespective of concomitant hepatocellular carcinoma

Melum, Espen; Friman, Styrbjörn; Bjøro, Kristian; Rasmussen, Allan; Isoniemi, Helena; Gjertsen, Henrik; Bäckman, Lars; Oksanen, Antti; Olausson, Michael; Duraj, Frans; Ericzon, Bo‐Göran

doi:10.1016/j.jhep.2007.06.013

Cited by 26 publications

(20 citation statements)

References 25 publications

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“…The Moya et al . study found that viral‐related aetiology of cirrhosis, tumour recurrence and older donor age remained the only independent predictors of survival after correcting for other variables …”

Section: Discussionmentioning

confidence: 93%

“…However 15 years later, the literature still fails to reach a consensus on the impact of HCV on survival post‐LT in patients with HCC. Some previous studies have demonstrated the independent negative impact of HCV on survival in patients transplanted with HCC whereas others have not . These studies are however limited at 5‐year survival.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Hepatitis C infection and hepatocellular carcinoma in liver transplantation: a 20‐year experience

Dumitra

Alabbad

Barkun

et al. 2013

HPB

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Hepatitis C infection and hepatocellular carcinoma in liver transplantation: a 20‐year experience

Dumitra

Alabbad

Barkun

et al. 2013

HPB

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“…HCV re-infection of the graft is universal and associated with accelerated progression of fibrosis, leading to graft cirrhosis in 10-30% of patients within 5 years [1,2]. The long-term survival of HCV-positive liver transplant recipients is, therefore, impaired [3,4].…”

Section: Introductionmentioning

confidence: 99%

Immune-mediated complications of the graft in interferon-treated hepatitis C positive liver transplant recipients

Selzner

Guindi

Renner

et al. 2011

Journal of Hepatology

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Hepatitis C virus (HCV) re-infection of the graft is universal and interferon based antiviral therapy remains at present the treatment of choice in HCV liver transplant recipients. Apart from the antiviral effects, interferon and ribavirin have both potent immunomodulatory properties resulting in a broad range of immune-related disorders including acute cellular rejection and chronic ductopenic rejection as well as de novo autoimmune hepatitis. Further complicating the picture, HCV infection per se is associated with a variety of autoimmune phenomena. We discuss here the immune-mediated complications and their relationship to chronic HCV and interferon based antiviral therapy.

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“…The number of transplants for chronic hepatitis C is increasing also in Scandinavia [2]. Recurrence of HCV in the graft is universal, the development of fibrosis more rapid and the prognosis worse in transplanted than in nontransplanted patients [3]. Hence, some 30% of transplanted patients will develop advanced fibrosis/cirrhosis within 5 years [1,4].…”

Section: Introductionmentioning

confidence: 99%

Concentration‐guided ribavirin dosing with darbepoetin support and peg‐IFN alfa‐2a for treatment of hepatitis C recurrence after liver transplantation

Ackefors

Gjertsen

Wernerson

et al. 2012

Journal of Viral Hepatitis

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Relapse of hepatitis C virus infection after liver transplantation is universal. Standard-of-care (SOC) treatment for relapse offers less satisfactory treatment response than in nontransplanted patients. Tolerance for treatment is suboptimal and withdrawals owing to adverse events induced by treatment frequent. To improve tolerance for SOC, and ribavirin (RBV) in particular, concentration-guided RBV dosing calculated by a formula taking renal function and weight into consideration was utilized. A serum RBV concentration of 10 μm was set as the goal. All patients were given maintenance darbepoetin therapy from 2 weeks prior to initiation of treatment. In total, 21 patients with a mean age of 52 (range 25-64) years were included. The mean RBV concentration at week 4 was 10.2 and 7.36 μm in genotype 1/4 and non-1/4 patients, respectively, and 11.7 and 9.42 at week 12. The mean haemoglobin drop was 25 g/L vs 21 g/L in the genotype 1/4 and non-1/4 group, respectively, a nonsignificant difference. With this treatment approach, 80-90% of patients could be kept adherent to treatment. Sustained viral response was achieved 8/16 (50%) with low-grade fibrosis (fibrosis stage ≤ 2) vs in none of five patients with advanced fibrosis (Fibrosis stage 3 and 4), P < 0.05. We conclude that a treatment algorithm utilizing concentration-guided RBV dosing during darbepoetin maintenance therapy substantially improves tolerance and allows high adherence to a SOC treatment schedule, and that therapy needs to be initiated before advanced fibrosis is developed.

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Hepatitis C impairs survival following liver transplantation irrespective of concomitant hepatocellular carcinoma

Cited by 26 publications

References 25 publications

Hepatitis C infection and hepatocellular carcinoma in liver transplantation: a 20‐year experience

Hepatitis C infection and hepatocellular carcinoma in liver transplantation: a 20‐year experience

Immune-mediated complications of the graft in interferon-treated hepatitis C positive liver transplant recipients

Concentration‐guided ribavirin dosing with darbepoetin support and peg‐IFN alfa‐2a for treatment of hepatitis C recurrence after liver transplantation

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