[Management of HCV cirrhosis in patients awaiting liver transplantation and prevention of hepatocellular carcinoma].

HCV correlated chronic hepatophaty represents one of the main causes of cirrhosis and, therefore, of orthotopic liver transplantation (OLT). Furthermore, it is known how the post-OLT recurrent chronic hepatitis C represents a main cause for the re-transplantation. Aim of the present review is the analysis of the natural history of HCV cirrhosis and the evaluation of the introduction form in waiting list. It has been examined the management of the main complications due to portal hypertension in patients awaiting OLT with particular reference to the use of TIPS (transjugular intrahepatic porto-systemic stent shunt) and possible antiviral treatment to obtain post-OLT HCV negativization. Finally, the problem of chemoprevention of hepatocellular carcinoma (HCC) has been considered. As a matter of fact, the treatment with Interferon (IFN) has led to undeniable benefits. Nevertheless, its use has not lowered the incidence of HCC. Probably, such an effect will be reached by means of a maintenance treatment with a small weekly dose of Pegylated IFN independently from virological response.