The Challenge of Recurrent Hepatitis C Virus in Liver Transplant Recipients

Hepatitis C virus (HCV) has become the leading indication for liver transplantation (LT) worldwide. Short-term graft and patient survival after LT in these individuals is comparable with other indications for LT. There is, however, a disturbing trend for decreased survival over the longer term. The...

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Main Author: Paul J Marotta
Format: Article
Language:English
Published: Wiley 2004-01-01
Series:Canadian Journal of Gastroenterology
Online Access:http://dx.doi.org/10.1155/2004/759124
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author Paul J Marotta
author_facet Paul J Marotta
author_sort Paul J Marotta
collection DOAJ
description Hepatitis C virus (HCV) has become the leading indication for liver transplantation (LT) worldwide. Short-term graft and patient survival after LT in these individuals is comparable with other indications for LT. There is, however, a disturbing trend for decreased survival over the longer term. The natural history of HCV infection after LT is evolving. Its early recurrence and the wide spectrum of recurrent disease is recognized, from minimal histological and clinical disease to very aggressive forms of hepatic damage such as fibrosing cholestatic hepatitis. There is growing concern that recurrent HCV is becoming more aggressive. Although many factors have been implicated, the causes have not been fully elucidated. Interferon-based antiviral therapy is challenging to use in this patient population because of significant toxicity. Nevertheless, these agents have some efficacy, and pegylated interferons, which are now being used more frequently, achieve superior response rates. The role of liver retransplantation in this patient population is controversial, because of both a reduced survival rate and an overall shortage of organ donors. The present review discusses the challenges that occur in LT recipients with HCV.
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spelling doaj-art-5af25458f52d4ec1a1a8dfcba889dcab2025-02-03T05:53:04ZengWileyCanadian Journal of Gastroenterology0835-79002004-01-0118Suppl C19C26C10.1155/2004/759124The Challenge of Recurrent Hepatitis C Virus in Liver Transplant RecipientsPaul J Marotta0Multi-Organ Transplant Program, London Health Sciences Centre, London, Ontario, CanadaHepatitis C virus (HCV) has become the leading indication for liver transplantation (LT) worldwide. Short-term graft and patient survival after LT in these individuals is comparable with other indications for LT. There is, however, a disturbing trend for decreased survival over the longer term. The natural history of HCV infection after LT is evolving. Its early recurrence and the wide spectrum of recurrent disease is recognized, from minimal histological and clinical disease to very aggressive forms of hepatic damage such as fibrosing cholestatic hepatitis. There is growing concern that recurrent HCV is becoming more aggressive. Although many factors have been implicated, the causes have not been fully elucidated. Interferon-based antiviral therapy is challenging to use in this patient population because of significant toxicity. Nevertheless, these agents have some efficacy, and pegylated interferons, which are now being used more frequently, achieve superior response rates. The role of liver retransplantation in this patient population is controversial, because of both a reduced survival rate and an overall shortage of organ donors. The present review discusses the challenges that occur in LT recipients with HCV.http://dx.doi.org/10.1155/2004/759124
spellingShingle Paul J Marotta
The Challenge of Recurrent Hepatitis C Virus in Liver Transplant Recipients
Canadian Journal of Gastroenterology
title The Challenge of Recurrent Hepatitis C Virus in Liver Transplant Recipients
title_full The Challenge of Recurrent Hepatitis C Virus in Liver Transplant Recipients
title_fullStr The Challenge of Recurrent Hepatitis C Virus in Liver Transplant Recipients
title_full_unstemmed The Challenge of Recurrent Hepatitis C Virus in Liver Transplant Recipients
title_short The Challenge of Recurrent Hepatitis C Virus in Liver Transplant Recipients
title_sort challenge of recurrent hepatitis c virus in liver transplant recipients
url http://dx.doi.org/10.1155/2004/759124
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