Liver Transplantation for Hepatitis C: Disease Management

Abstract

Hepatitis C-positive liver transplantation (LT) patients present significant problems in post-transplant management. These patients are known to have more rapid fibrosis progression, and outcomes are worsening in the population, compared to other indications for LT. Decisions regarding selection of immunosuppressants and treatment of rejection are different in these patients, because both may alter the course of progression. HCV recurs universally, and treatment of recurrence is fraught with difficulties in tolerability and low response rates. One option for treating these patients is retransplantation, but this option, too, is controversial. This review discusses each of these issues in detail.