Delisting HCV-infected liver transplant candidates who improved after viral eradication

the European Liver and Intestine Transplant Association (ELITA), Giovanni Perricone, Christophe Duvoux, Marina Berenguer, Paolo A. Cortesi, Carmen Vinaixa, Rita Facchetti, Chiara Mazzarelli, Susanne Rasoul Rockenschaub, Silvia Martini, Cristina Morelli, Sara Monico, Riccardo Volpes, Georges Philippe Pageaux, Stefano Fagiuoli, Luca S. Belli

Research output: Contribution to journalArticle

Abstract

Backgrounds & Aims: Treating patients with decompensated cirrhosis with direct-acting antiviral (DAA) therapy while on the waiting list for liver transplantation results in substantial improvement of liver function allowing 1 in 4 patients to be removed from the waiting list or delisted, as reported in a previous study promoted by the European Liver and Intestine Transplant Association (ELITA). The aim of this study was to report on clinical outcomes of delisted patients, including mortality risk, hepatocellular carcinoma development and clinical decompensation requiring relisting. Methods: One hundred and forty-two HCV-positive patients on the liver transplant waiting list for decompensated cirrhosis, negative for hepatocellular carcinoma, between February 2014 and June 2015 were treated with DAA therapy and were prospectively followed up. Results: Forty-four patients (30.9%) were delisted following clinical improvement. This percentage was higher than in the original study because of a number of patients being delisted long after starting DAAs. The median Child-Pugh and MELD score of delisted patients was 5.5 and 9 respectively. Four patients were relisted, because of HCC diagnosis in 1 case and 3 patients developed ascites. One further patient died (2.4%) because of rapidly progressing hepatocellular carcinoma twenty-two months after delisting. Of the 70 patients who received a liver graft, 9 died (13%). Conclusions: Antiviral therapy allows for a long-term improvement of liver function and the delisting of one-third of treated patients with risk of liver-related complications after delisting being very low.
Original languageEnglish
Pages (from-to)2170-2177
Number of pages8
JournalLiver International
Volume38
Issue number12
DOIs
Publication statusPublished - Dec 1 2018

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Transplants
Liver
Waiting Lists
Antiviral Agents
Hepatocellular Carcinoma
Fibrosis
Ascites
Liver Transplantation
Therapeutics
Mortality

Keywords

  • cirrhosis
  • delisting
  • direct-acting antivirals
  • liver transplantation

Cite this

(ELITA), T. E. L. A. I. T. A., Perricone, G., Duvoux, C., Berenguer, M., Cortesi, P. A., Vinaixa, C., ... Belli, L. S. (2018). Delisting HCV-infected liver transplant candidates who improved after viral eradication. Liver International, 38(12), 2170-2177. https://doi.org/10.1111/liv.13878

Delisting HCV-infected liver transplant candidates who improved after viral eradication. / (ELITA), the European Liver and Intestine Transplant Association; Perricone, Giovanni; Duvoux, Christophe; Berenguer, Marina; Cortesi, Paolo A.; Vinaixa, Carmen; Facchetti, Rita; Mazzarelli, Chiara; Rockenschaub, Susanne Rasoul; Martini, Silvia; Morelli, Cristina; Monico, Sara; Volpes, Riccardo; Pageaux, Georges Philippe; Fagiuoli, Stefano; Belli, Luca S.

In: Liver International, Vol. 38, No. 12, 01.12.2018, p. 2170-2177.

Research output: Contribution to journalArticle

(ELITA), TELAITA, Perricone, G, Duvoux, C, Berenguer, M, Cortesi, PA, Vinaixa, C, Facchetti, R, Mazzarelli, C, Rockenschaub, SR, Martini, S, Morelli, C, Monico, S, Volpes, R, Pageaux, GP, Fagiuoli, S & Belli, LS 2018, 'Delisting HCV-infected liver transplant candidates who improved after viral eradication', Liver International, vol. 38, no. 12, pp. 2170-2177. https://doi.org/10.1111/liv.13878
(ELITA) TELAITA, Perricone G, Duvoux C, Berenguer M, Cortesi PA, Vinaixa C et al. Delisting HCV-infected liver transplant candidates who improved after viral eradication. Liver International. 2018 Dec 1;38(12):2170-2177. https://doi.org/10.1111/liv.13878
(ELITA), the European Liver and Intestine Transplant Association ; Perricone, Giovanni ; Duvoux, Christophe ; Berenguer, Marina ; Cortesi, Paolo A. ; Vinaixa, Carmen ; Facchetti, Rita ; Mazzarelli, Chiara ; Rockenschaub, Susanne Rasoul ; Martini, Silvia ; Morelli, Cristina ; Monico, Sara ; Volpes, Riccardo ; Pageaux, Georges Philippe ; Fagiuoli, Stefano ; Belli, Luca S. / Delisting HCV-infected liver transplant candidates who improved after viral eradication. In: Liver International. 2018 ; Vol. 38, No. 12. pp. 2170-2177.
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abstract = "Backgrounds & Aims: Treating patients with decompensated cirrhosis with direct-acting antiviral (DAA) therapy while on the waiting list for liver transplantation results in substantial improvement of liver function allowing 1 in 4 patients to be removed from the waiting list or delisted, as reported in a previous study promoted by the European Liver and Intestine Transplant Association (ELITA). The aim of this study was to report on clinical outcomes of delisted patients, including mortality risk, hepatocellular carcinoma development and clinical decompensation requiring relisting. Methods: One hundred and forty-two HCV-positive patients on the liver transplant waiting list for decompensated cirrhosis, negative for hepatocellular carcinoma, between February 2014 and June 2015 were treated with DAA therapy and were prospectively followed up. Results: Forty-four patients (30.9{\%}) were delisted following clinical improvement. This percentage was higher than in the original study because of a number of patients being delisted long after starting DAAs. The median Child-Pugh and MELD score of delisted patients was 5.5 and 9 respectively. Four patients were relisted, because of HCC diagnosis in 1 case and 3 patients developed ascites. One further patient died (2.4{\%}) because of rapidly progressing hepatocellular carcinoma twenty-two months after delisting. Of the 70 patients who received a liver graft, 9 died (13{\%}). Conclusions: Antiviral therapy allows for a long-term improvement of liver function and the delisting of one-third of treated patients with risk of liver-related complications after delisting being very low.",
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AU - Duvoux, Christophe

AU - Berenguer, Marina

AU - Cortesi, Paolo A.

AU - Vinaixa, Carmen

AU - Facchetti, Rita

AU - Mazzarelli, Chiara

AU - Rockenschaub, Susanne Rasoul

AU - Martini, Silvia

AU - Morelli, Cristina

AU - Monico, Sara

AU - Volpes, Riccardo

AU - Pageaux, Georges Philippe

AU - Fagiuoli, Stefano

AU - Belli, Luca S.

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N2 - Backgrounds & Aims: Treating patients with decompensated cirrhosis with direct-acting antiviral (DAA) therapy while on the waiting list for liver transplantation results in substantial improvement of liver function allowing 1 in 4 patients to be removed from the waiting list or delisted, as reported in a previous study promoted by the European Liver and Intestine Transplant Association (ELITA). The aim of this study was to report on clinical outcomes of delisted patients, including mortality risk, hepatocellular carcinoma development and clinical decompensation requiring relisting. Methods: One hundred and forty-two HCV-positive patients on the liver transplant waiting list for decompensated cirrhosis, negative for hepatocellular carcinoma, between February 2014 and June 2015 were treated with DAA therapy and were prospectively followed up. Results: Forty-four patients (30.9%) were delisted following clinical improvement. This percentage was higher than in the original study because of a number of patients being delisted long after starting DAAs. The median Child-Pugh and MELD score of delisted patients was 5.5 and 9 respectively. Four patients were relisted, because of HCC diagnosis in 1 case and 3 patients developed ascites. One further patient died (2.4%) because of rapidly progressing hepatocellular carcinoma twenty-two months after delisting. Of the 70 patients who received a liver graft, 9 died (13%). Conclusions: Antiviral therapy allows for a long-term improvement of liver function and the delisting of one-third of treated patients with risk of liver-related complications after delisting being very low.

AB - Backgrounds & Aims: Treating patients with decompensated cirrhosis with direct-acting antiviral (DAA) therapy while on the waiting list for liver transplantation results in substantial improvement of liver function allowing 1 in 4 patients to be removed from the waiting list or delisted, as reported in a previous study promoted by the European Liver and Intestine Transplant Association (ELITA). The aim of this study was to report on clinical outcomes of delisted patients, including mortality risk, hepatocellular carcinoma development and clinical decompensation requiring relisting. Methods: One hundred and forty-two HCV-positive patients on the liver transplant waiting list for decompensated cirrhosis, negative for hepatocellular carcinoma, between February 2014 and June 2015 were treated with DAA therapy and were prospectively followed up. Results: Forty-four patients (30.9%) were delisted following clinical improvement. This percentage was higher than in the original study because of a number of patients being delisted long after starting DAAs. The median Child-Pugh and MELD score of delisted patients was 5.5 and 9 respectively. Four patients were relisted, because of HCC diagnosis in 1 case and 3 patients developed ascites. One further patient died (2.4%) because of rapidly progressing hepatocellular carcinoma twenty-two months after delisting. Of the 70 patients who received a liver graft, 9 died (13%). Conclusions: Antiviral therapy allows for a long-term improvement of liver function and the delisting of one-third of treated patients with risk of liver-related complications after delisting being very low.

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