Delisting and clinical outcomes of liver transplant candidates after hepatitis C virus eradication: A long-term single-center experience.
Clin Res Hepatol Gastroenterol
; 45(6): 101714, 2021 11.
Article
em En
| MEDLINE
| ID: mdl-33930587
ABSTRACT
BACKGROUND:
Previous short-term studies have reported on liver function improvements and delisting among liver transplantation (LT) candidates with hepatitis C virus (HCV) and decompensated liver cirrhosis after successful antiviral therapy. This study aimed to evaluate the long-term impact of HCV eradication on liver function, portal hypertension, probability of delisting, and clinical outcomes in patients awaiting LT.METHODS:
Forty-five LT candidates with decompensated HCV cirrhosis were prospectively observed after HCV eradication by direct-acting antiviral therapy. The median follow-up (FU) time was 24 months.RESULTS:
Twenty-six (57.8%) patients were delisted due to clinical improvement. Multivariate analysis revealed male gender (hazard ratio (HR) 3.28; pâ¯=â¯0.022), baseline Child - Turcotte - Pugh class C (HR 4.81; pâ¯=â¯0.003), and delta prothrombin index <2% between baseline and the time of sustained virological response (HR 3.82; pâ¯=â¯0.01) as independent risk factors for non-delisting. During a median FU of 21 months after delisting, hepatocellular carcinoma (HCC) developed in 2 (7.7%) patients. Among non-delisted patients, HCC developed in 6 (31.6%) cases, variceal bleeding developed in 3 (15.8%) patients, and spontaneous bacterial peritonitis developed in 2 (10.5%) patients.CONCLUSION:
HCV eradication lead to the delisting of more than 50% of patients, but did not eliminate the HCC risk, and close monitoring of patients should continue after the end of treatment.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transplante de Fígado
/
Hepatite C
/
Erradicação de Doenças
Tipo de estudo:
Risk_factors_studies
Limite:
Humans
/
Male
Idioma:
En
Revista:
Clin Res Hepatol Gastroenterol
Ano de publicação:
2021
Tipo de documento:
Article