Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

22 September 2017 : Original article  

Single-Center Experience in Pre-transplant Hepatitis C Virus (HCV) Treatment Among Living Donor Liver Transplant Candidates: Bridging the Direct-Acting Antivirals (DAA)

Ashwini M. Niranjan-Azadi1BCDEF, Gokhan Kabacam2EF, Christine M. Durand3ABCDE, Saad Anjum4DE, Behnam Saberi2DE, Nabil N. Dagher5ABDE, Benjamin Philosophe6DE, Ahmet Gurakar2BDEF*

DOI: 10.12659/AOT.905649

Ann Transplant 2017; 22:570-574


BACKGROUND: Treatment with DAAs before deceased donor liver transplantation has been shown to be an effective strategy to prevent post-transplant HCV recurrence, with a 95% cure-rate among individuals who achieve undetectable HCV VL for ≥30 days pre- transplant. This strategy has not been evaluated in LDLT.

MATERIAL AND METHODS: We evaluated outcomes in LDLT recipients treated with DAAs pre-transplant and bridged with 4 weeks of post-transplant SOF. All cases of LDLT at Johns Hopkins (1/1/2014-3/1/15) were retrospectively reviewed.

RESULTS: There were 4 HCV+ LDLT cases treated with DAAs pre- and post-transplant. Pre-transplant DAA regimens included SOF plus SIM in 2 cases of HCC and SOF plus RBV in 2 cases of ESLD. All patients achieved negative VL by week 7 of treatment and all patients had at least 30 days of HCV RNA negativity at the time of LDLT. Patient 4 had a delay in LDLT due to uncontrolled pulmonary hypertension, and experienced viral breakthrough because of treatment interruption. Due to concerns for SOF resistance, a salvage regimen of LDV-SOF and SIM was used. Post-LDLT patients 1–3 received 4 weeks of SOF monotherapy and patient 4 received 14 weeks of LDV-SOF. Three patients achieved SVR12. One died from non-HCV related complications at 4 months post-LDLT.

CONCLUSIONS: Our preliminary experience suggests that bridging DAAs pre- and post-LDLT is an effective strategy to prevent HCV recurrence. With delays in transplant and prolonged use of SOF/RBV, there is a risk of viral breakthrough, but a salvage strategy of triple DAA therapy can be effective.

Keywords: Hepatitis C, Liver Transplantation

Add Comment 0 Comments

938 7

In Press

10 Nov 2023 : Original article  

Effects of Preservation of Donor Liver Gastroduodenal Artery on Post-Transplant Biliary Complications in 18...

Ann Transplant In Press; DOI:  

07 Nov 2023 : Original article  

Allogeneic Hematopoietic Stem Cell Transplantation Can Improve Prognosis of Extramedullary Infiltration Pos...

Ann Transplant In Press; DOI:  

06 Nov 2023 : Original article  

Clinical Outcomes of Administration of Rituximab for Desensitization in Liver Transplant Patients with Pref...

Ann Transplant In Press; DOI:  

06 Nov 2023 : Original article  

Short-Term Monitoring of Graft Regeneration in Partial Liver Transplantation Recipients

Ann Transplant In Press; DOI:  

Most Viewed Current Articles

24 Aug 2021 : Review article  

Normothermic Machine Perfusion (NMP) of the Liver – Current Status and Future Perspectives

DOI :10.12659/AOT.931664

Ann Transplant 2021; 26:e931664

26 Jan 2022 : Review article  

Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models

DOI :10.12659/AOT.934924

Ann Transplant 2022; 27:e934924

29 Dec 2021 : Original article  

Efficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...

DOI :10.12659/AOT.933588

Ann Transplant 2021; 26:e933588

15 Mar 2022 : Case report  

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358