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Retransplantation for HCV-Related Liver Disease

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Hepatitis C Virus and Liver Transplantation

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Abstract

Liver failure from Hepatitis C virus (HCV) is the most common indication for primary liver transplant in the United States, and it recurs in virtually 100 % of recipients with detectable virus going into transplant. HCV also represents the etiology with the worst posttransplant patient survival outcomes, and therefore retransplantation is a frequent consideration for patients with recurrent HCV. Decisions about retransplant in patients with HCV recurrence are ethically challenging. Several models to determine need for retransplant and to predict postretransplant outcomes have been investigated in order to help guide retransplant decisions, but no consensus recommendations have been made. Expanding the donor pool by using more donation after cardiac death liver grafts may improve availability for patients with HCV-related graft failure, but this approach is controversial. New HCV therapies are likely to become available within the next few years that could drastically alter the posttransplant course of patients with HCV and may reduce the need for retransplant over time.

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Acknowledgments

The authors would like to thank Jennifer Dodge, MPH for her assistance with data summaries and calculations regarding the donor trends. This work was funded in part by grants from the National Institute of Diabetes and Digestive and Kidney Diseases (DK076565) and from Agency for Healthcare Research and Quality (DK076565) to S.W.B. and from the National Institute of Health (5T32DK07038) to J.P.W.

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Authors and Affiliations

  1. University of Colorado, 1635 Aurora Ct. Mail Stop B-154, 80045, Aurora, CO, USA

    Joel P. Wedd MD, MPH & Scott W. Biggins MD, MAS

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  1. Joel P. Wedd MD, MPH
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  2. Scott W. Biggins MD, MAS
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Correspondence to Joel P. Wedd MD, MPH .

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  1. La Fe Hospital, University of Valencia and Ciberehd, Valencia, Spain

    Marina Berenguer

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Wedd, J., Biggins, S. (2014). Retransplantation for HCV-Related Liver Disease. In: Berenguer, M. (eds) Hepatitis C Virus and Liver Transplantation. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8438-7_7

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  • DOI: https://doi.org/10.1007/978-1-4614-8438-7_7

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