Abstract
Hepatitis C is the most common indication for liver transplantation in the United States. Reinfection is a universal occurrence in patients who are transplanted with viremia, and recurrent hepatitis results in higher rates of graft and patient loss compared to other indications for transplantation. The most important factors that predict poor transplant outcome are advanced donor age and treatment of acute rejection. Therapy may be given prior to transplantation to eradicate virus and prevent recurrent disease. Alternatively, posttransplantation therapy can be administered prior to the development of overt clinical disease (early or preemptive therapy) or delayed until histological progression is evident. However, posttransplantation therapy with interferon and ribavirin is problematic due to a high incidence of treatment complications and low sustained virologic response rate. New therapies that are more uniformly effective and better tolerated are needed to improve virologic response rates and ultimately reduce the rates of cirrhosis and graft loss.
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Terrault, N.A., Pessoa, M.G. (2009). Pre- and Posttransplant Management of Hepatitis C. In: Trotter, J., Everson, G. (eds) Liver Transplantation. Clinical Gastroenterology. Humana Press. https://doi.org/10.1007/978-1-60327-028-1_3
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