Evidence map›Paper›PMID 30775356›Full record

ArticleCanadian journal of gastroenterology & hepatology2019

HCV Eradication with Direct-Acting Antivirals Does Not Impact HCC Progression on the Waiting List or HCC Recurrence after Liver Transplantation.

Juliet A Emamaullee, Mariusz Bral, Glenda Meeberg, Aldo J Montano-Loza, Vincent G Bain, Kelly Warren Burak, David Bigam, A M James Shapiro, Norman Kneteman

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In one paragraph

Article in Canadian journal of gastroenterology & hepatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Juliet A EmamaulleeDivision of Transplantation, Department of Surgery, University of Alberta, Edmonton, AB, Canada.ORCID 0000-0003-4238-3057
Mariusz BralDivision of Transplantation, Department of Surgery, University of Alberta, Edmonton, AB, Canada.
Glenda MeebergDivision of Transplantation, Department of Surgery, University of Alberta, Edmonton, AB, Canada.
Aldo J Montano-LozaDivision of Gastroenterology & Liver Unit, University of Alberta, Edmonton, AB, Canada.
Vincent G BainDivision of Gastroenterology & Liver Unit, University of Alberta, Edmonton, AB, Canada.
Kelly Warren BurakDivision of Gastroenterology & Hepatology, University of Calgary, Calgary, AB, Canada.
David BigamDivision of Transplantation, Department of Surgery, University of Alberta, Edmonton, AB, Canada.ORCID 0000-0003-2285-4173
A M James ShapiroDivision of Transplantation, Department of Surgery, University of Alberta, Edmonton, AB, Canada.ORCID 0000-0003-1843-2816
Norman KnetemanDivision of Transplantation, Department of Surgery, University of Alberta, Edmonton, AB, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The introduction of direct-acting antivirals (DAA) for HCV has led to high rates of HCV eradication. Treatment of patients awaiting liver transplantation (LT) has been controversial. Recent data suggests that DAA treatment may accelerate recurrent HCC. The impact of DAA on delisting for HCC progression or recurrent HCC post-LT has not been well characterized. Methods: A retrospective review of both waitlist patients and LT recipients at a single institution was performed. Patient demographics, HCV treatment, HCC features and treatments, biopsy results, and graft and patient survival were evaluated. Patients on the LT waitlist or who were transplanted between January 2014 and December 2015 were included. Data was collected through December 2017 to have a minimum of two years of follow-up. Results: In the study period, 128 adult LT were performed. 44 patients were HCV+, and 68.2% (N=30) also had HCC. 38.6% (N=17) of HCV+ patients received DAA pre-LT, and 94.1% (N=16/17) achieved sustained virologic response (SVR) pre-LT. Among untreated HCV+ patients who underwent LT, 81.5% (N=22/27) received DAA post-LT, with 82.6% achieving SVR post-LT (N=18/22). 82.1% (N=23/28) of untreated post-LT patients underwent liver biopsy prior to therapy, and 52.2% had at least F1 METAVIR fibrosis. 87.5% (N=14/16) of active waitlist patients received DAA and achieved SVR. HCV eradication did not result in higher rates of delisting for HCC progression. Due to local HCC listing criteria of total tumor volume and AFP, 60% (N=18/30) of HCV+/HCC patients were beyond Milan criteria at the time of LT. Despite this, there was no difference in HCC recurrence rates post-LT, whether patients achieved SVR pre- or post-LT. Conclusions: These data suggest that HCV eradication pre-LT does not significantly impact waitlist time for HCV+ patients with HCC. HCV eradication does not impact rates of delisting for HCC progression or rates of HCC recurrence post-LT.

Indexed as

AdolescentAdultAgedAntiviral AgentsCarcinoma, HepatocellularDisease ProgressionFemaleFollow-Up StudiesHepatitis CHumansLiver NeoplasmsLiver TransplantationMaleMiddle AgedRetrospective StudiesTime FactorsAntiviral Agents

Identifiers

PMID30775356
PMCPMC6354133

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.