A practical guide to the management of hcv infection following liver transplantation

K. Watt, B. Veldt, M. Charlton

Research output: Contribution to journalShort survey

90 Scopus citations

Abstract

Hepatitis C-associated liver failure is the most common indication for liver transplantation, with virological recurrence near ubiquitous. Approximately 30% of HCV-infected recipients will die or lose their allograft or develop cirrhosis secondary to hepatitis C recurrence by the fifth postoperative year, with the proportion increasing with duration of follow-up. Strategies for minimizing the frequency of severe HCV recurrence include avoidance of older donors, early diagnosis/treatment of CMV and minimization of immunosuppression, particularly T-cell depleting therapies and pulsed corticosteroid treatment of acute cellular rejection. Patients should be offered treatment with peginterferon and ribavirin before LT if MELD ≤ 17 or as soon as histological evidence of recurrence of HCV is apparent post-LT. Because of the high frequency of hemotoxicity and renal insufficiency, ribavirin should be dosed according to renal function.

Original languageEnglish (US)
Pages (from-to)1707-1713
Number of pages7
JournalAmerican Journal of Transplantation
Volume9
Issue number8
DOIs
StatePublished - Aug 1 2009

Keywords

  • HCV
  • Immunosuppression
  • Liver transplantation
  • Recurrence
  • Treatment

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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