ArticleWorld journal of hepatology2017
Is it time to rethink combined liver-kidney transplant in hepatitis C patients with advanced fibrosis?
Article in World journal of hepatology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimTo reduce hepatic and extrahepatic complications of chronic hepatitis C in kidney transplant recipients.
methodsWe conducted a systematic review of kidney only transplant in patients with hepatitis C and advanced fibrosis.
resultsThe 5 year patient survival of kidney transplant recipients with and without hepatitis C cirrhosis ranged from 31% to 90% and 85% to 92%, respectively. Hepatitis C kidney transplant recipients had lower 10-year survival when compared to hepatitis B patients, 40% and 90% respectively. There were no studies that included patients with virologic cure prior to kidney transplant that reported post-kidney transplant outcomes. There were no studies of direct acting antiviral therapy and effect on patient or graft survival after kidney transplantation.
conclusionData on kidney transplant only in hepatitis C patients that reported inferior outcomes were prior to the development of potent direct acting antiviral. With the development of potent directing acting antiviral therapy for hepatitis C with high cure rates studies are needed to determine if patients with hepatitis C, including those with advanced fibrosis, can undergo kidney transplant alone with acceptable long term outcomes.
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