Bushyhead Daniel, Goldberg David
Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.; Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Curr Hepatol Rep. 2017 Mar;16(1):12-17. doi: 10.1007/s11901-017-0327-0. Epub 2017 Jan 26.
The purpose of this article is to review recent literature regarding the use of Hepatitis C virus (HCV) positive donor livers in liver transplantation. Given the prevalence of HCV-positive patients on the waitlist coupled with high waitlist mortality, use of HCV-positive livers may be a means to meet patient needs. This review seeks to primarily answer the following questions: can HCV-positive livers be used safely and effectively? Are new direct acting antiviral medications safe and effective in HCV-positive liver recipients?
Use of HCV-positive donor livers for liver transplantation in HCV-positive recipients is increasing. These donor livers have equivalent patient and graft survival when compared to HCV-negative donor livers in HCV-positive liver transplant recipients. Recent studies suggest that use of direct acting antiviral medications in HCV-positive liver transplant recipients can be successful, although there is insufficient data for their use in recipients of HCV-positive donor livers.
HCV-positive donor livers may be safely and effectively used in HCV-positive liver transplant recipients. Direct acting antiviral medications appear safe and effective in HCV-positive liver transplant recipients, but data on their efficacy in HCV-positive liver transplant recipients are limited. Future research should focus on the use of HCV-positive donor livers in HCV-negative liver transplant recipients.
本文旨在综述近期有关肝移植中使用丙型肝炎病毒(HCV)阳性供肝的文献。鉴于等待名单上HCV阳性患者的普遍性以及等待名单上的高死亡率,使用HCV阳性肝脏可能是满足患者需求的一种手段。本综述主要旨在回答以下问题:HCV阳性肝脏能否安全有效地使用?新型直接作用抗病毒药物在HCV阳性肝移植受者中是否安全有效?
HCV阳性受者使用HCV阳性供肝进行肝移植的情况正在增加。在HCV阳性肝移植受者中,与HCV阴性供肝相比,这些供肝的患者和移植物存活率相当。近期研究表明,在HCV阳性肝移植受者中使用直接作用抗病毒药物可能会成功,尽管在HCV阳性供肝受者中使用的数据不足。
HCV阳性供肝可安全有效地用于HCV阳性肝移植受者。直接作用抗病毒药物在HCV阳性肝移植受者中似乎安全有效,但关于其在HCV阳性肝移植受者中的疗效数据有限。未来的研究应侧重于HCV阳性供肝在HCV阴性肝移植受者中的使用。