Preemptive therapy for hepatitis C virus after living-donor liver transplantation

[Guest guest]

Transplantation. 2004 Nov 15;78(9):1308-11.

Preemptive therapy for hepatitis C virus after living-donor liver

transplantation.

Sugawara Y, Makuuchi M, Matsui Y, Kishi Y, Akamatsu N, Kaneko J, Kokudo N.

Artificial Organ and Transplantation Division, Department of Surgery,

Graduate School of Medicine, University of Tokyo, Tokyo, Japan.

BACKGROUND.: Living-donor liver transplantation (LDLT) is important for

patients with end-stage viral hepatitis because of the cadaveric organ

shortage. Preliminary results, however, indicate that LDLT might be

disadvantageous for patients positive for hepatitis C virus (HCV). METHODS.:

The subjects were 23 patients who underwent LDLT for HCV cirrhosis. All the

patients preemptively received antiviral therapy consisting of

interferon-alfa2b and ribavirin, which was started approximately 1 month

after the operation. The therapy continued for 12 months after the first

negative HCV RNA test. The patients were then observed without the therapy

for 6 months (group 1). The therapy was continued for at least 12 months

even when the HCV RNA test remained positive (group 2). The subjects were

removed from the protocol if they could not continue the therapy for 12

months because of adverse effects or could not start the therapy because of

early death. RESULTS.: Eight patients were removed from the protocol. Nine

patients were assigned to group 1 and the other six to group 2. The

sustained virologic response ratio was 39% (9 of 23). There was a

significant difference between the groups in the histologic activity score 1

year after the therapy. The cumulated 3-year survival of the HCV-positive

patients was 85%, which was comparable with that of patients negative for

HCV (n=93 [90%]). CONCLUSIONS.: The present preemptive antiviral protocol

after LDLT is safe and might warrant a controlled study for confirming its

benefit on graft survival.

PMID: 15548968 [PubMed - in process]

[Guest guest]

Transplantation. 2004 Nov 15;78(9):1308-11.

Preemptive therapy for hepatitis C virus after living-donor liver

transplantation.

Sugawara Y, Makuuchi M, Matsui Y, Kishi Y, Akamatsu N, Kaneko J, Kokudo N.

Artificial Organ and Transplantation Division, Department of Surgery,

Graduate School of Medicine, University of Tokyo, Tokyo, Japan.

BACKGROUND.: Living-donor liver transplantation (LDLT) is important for

patients with end-stage viral hepatitis because of the cadaveric organ

shortage. Preliminary results, however, indicate that LDLT might be

disadvantageous for patients positive for hepatitis C virus (HCV). METHODS.:

The subjects were 23 patients who underwent LDLT for HCV cirrhosis. All the

patients preemptively received antiviral therapy consisting of

interferon-alfa2b and ribavirin, which was started approximately 1 month

after the operation. The therapy continued for 12 months after the first

negative HCV RNA test. The patients were then observed without the therapy

for 6 months (group 1). The therapy was continued for at least 12 months

even when the HCV RNA test remained positive (group 2). The subjects were

removed from the protocol if they could not continue the therapy for 12

months because of adverse effects or could not start the therapy because of

early death. RESULTS.: Eight patients were removed from the protocol. Nine

patients were assigned to group 1 and the other six to group 2. The

sustained virologic response ratio was 39% (9 of 23). There was a

significant difference between the groups in the histologic activity score 1

year after the therapy. The cumulated 3-year survival of the HCV-positive

patients was 85%, which was comparable with that of patients negative for

HCV (n=93 [90%]). CONCLUSIONS.: The present preemptive antiviral protocol

after LDLT is safe and might warrant a controlled study for confirming its

benefit on graft survival.

PMID: 15548968 [PubMed - in process]

[Guest guest]

Transplantation. 2004 Nov 15;78(9):1308-11.

Preemptive therapy for hepatitis C virus after living-donor liver

transplantation.

Sugawara Y, Makuuchi M, Matsui Y, Kishi Y, Akamatsu N, Kaneko J, Kokudo N.

Artificial Organ and Transplantation Division, Department of Surgery,

Graduate School of Medicine, University of Tokyo, Tokyo, Japan.

BACKGROUND.: Living-donor liver transplantation (LDLT) is important for

patients with end-stage viral hepatitis because of the cadaveric organ

shortage. Preliminary results, however, indicate that LDLT might be

disadvantageous for patients positive for hepatitis C virus (HCV). METHODS.:

The subjects were 23 patients who underwent LDLT for HCV cirrhosis. All the

patients preemptively received antiviral therapy consisting of

interferon-alfa2b and ribavirin, which was started approximately 1 month

after the operation. The therapy continued for 12 months after the first

negative HCV RNA test. The patients were then observed without the therapy

for 6 months (group 1). The therapy was continued for at least 12 months

even when the HCV RNA test remained positive (group 2). The subjects were

removed from the protocol if they could not continue the therapy for 12

months because of adverse effects or could not start the therapy because of

early death. RESULTS.: Eight patients were removed from the protocol. Nine

patients were assigned to group 1 and the other six to group 2. The

sustained virologic response ratio was 39% (9 of 23). There was a

significant difference between the groups in the histologic activity score 1

year after the therapy. The cumulated 3-year survival of the HCV-positive

patients was 85%, which was comparable with that of patients negative for

HCV (n=93 [90%]). CONCLUSIONS.: The present preemptive antiviral protocol

after LDLT is safe and might warrant a controlled study for confirming its

benefit on graft survival.

PMID: 15548968 [PubMed - in process]

[Guest guest]

Transplantation. 2004 Nov 15;78(9):1308-11.

Preemptive therapy for hepatitis C virus after living-donor liver

transplantation.

Sugawara Y, Makuuchi M, Matsui Y, Kishi Y, Akamatsu N, Kaneko J, Kokudo N.

Artificial Organ and Transplantation Division, Department of Surgery,

Graduate School of Medicine, University of Tokyo, Tokyo, Japan.

BACKGROUND.: Living-donor liver transplantation (LDLT) is important for

patients with end-stage viral hepatitis because of the cadaveric organ

shortage. Preliminary results, however, indicate that LDLT might be

disadvantageous for patients positive for hepatitis C virus (HCV). METHODS.:

The subjects were 23 patients who underwent LDLT for HCV cirrhosis. All the

patients preemptively received antiviral therapy consisting of

interferon-alfa2b and ribavirin, which was started approximately 1 month

after the operation. The therapy continued for 12 months after the first

negative HCV RNA test. The patients were then observed without the therapy

for 6 months (group 1). The therapy was continued for at least 12 months

even when the HCV RNA test remained positive (group 2). The subjects were

removed from the protocol if they could not continue the therapy for 12

months because of adverse effects or could not start the therapy because of

early death. RESULTS.: Eight patients were removed from the protocol. Nine

patients were assigned to group 1 and the other six to group 2. The

sustained virologic response ratio was 39% (9 of 23). There was a

significant difference between the groups in the histologic activity score 1

year after the therapy. The cumulated 3-year survival of the HCV-positive

patients was 85%, which was comparable with that of patients negative for

HCV (n=93 [90%]). CONCLUSIONS.: The present preemptive antiviral protocol

after LDLT is safe and might warrant a controlled study for confirming its

benefit on graft survival.

PMID: 15548968 [PubMed - in process]