ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2019
Cost Effectiveness of Transplanting HCV-Infected Livers Into Uninfected Recipients With Preemptive Antiviral Therapy.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
What it found
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Who cites it
10 citing papers in PubMed.
- Expanding the liver donor pool worldwide with hepatitis C infected livers, is it the time?World journal of transplantation · 2024Review
- Quality-adjusted life years and surgical waiting list: Systematic review of the literature.World journal of gastrointestinal surgery · 2024Article
- Transplanting Organs from Donors with HIV or Hepatitis C: The Viral Frontier.World journal of surgery · 2021Review
- Cost-Effectiveness of Utilization of Hepatitis B Virus-Positive Liver Donors for HBV-Negative Transplant Recipients.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Cost-effectiveness of using hepatitis C viremic hearts for transplantation into HCV-negative recipients.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Article
- Immediate administration of antiviral therapy after transplantation of hepatitis C-infected livers into uninfected recipients: Implications for therapeutic planning.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2020Article
- Evolving Cell-Based and Cell-Free Clinical Strategies for Treating Severe Human Liver Diseases.Cells · 2020Review
- Expanding the donor pool: Hepatitis C, hepatitis B and human immunodeficiency virus-positive donors in liver transplantation.World journal of gastroenterology · 2019Review
- When Theory Becomes Reality: Navigating the Ethics of Transplanting Hepatitis C Virus-Positive Livers Into Negative Recipients.Clinical liver disease · 2019Review
- Liver transplantation for hepatitis C virus (HCV) non-viremic recipients with HCV viremic donors.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2019Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
BACKGROUND &
aimsGuidelines do not recommend transplanting hepatitis C virus (HCV)-infected livers into HCV-uninfected recipients. Direct-acting antivirals (DAAs) can be used to treat donor-derived HCV infection. However, the added cost of DAA therapy is a barrier. We evaluated the cost effectiveness of transplanting HCV-positive livers into HCV-negative patients with preemptive DAA therapy.
methodsA previously validated Markov-based mathematical model was adapted to simulate a virtual trial of HCV-negative patients on the liver transplant waitlist. The model compared long-term clinical and economic outcomes in patients willing to accept only HCV-negative livers vs those willing to accept any liver (HCV negative or HCV positive). Recipients of HCV-positive livers received 12 weeks of preemptive DAA therapy. The model incorporated data from the United Network for Organ Sharing and published sources.
resultsFor patients with a model for end-stage liver disease (MELD) score ≥ 22, accepting any liver vs waiting for only HCV-negative livers was cost effective, with incremental cost-effectiveness ratios ranging from $56,100 to $91,700/quality-adjusted life-year. For patients with a MELD score of 28 (the median MELD score of patients undergoing transplantation in the United States), accepting any liver was cost effective at an incremental cost-effectiveness ratio of $62,600/quality-adjusted life year. In patients with low MELD scores, which may not accurately reflect disease severity, accepting any liver was cost effective, irrespective of MELD score.
conclusionsUsing a Markov-based mathematical model, we found transplanting HCV-positive livers into HCV-negative patients with preemptive DAA therapy to be a cost-effective strategy that could improve health outcomes.
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