Abstract | BACKGROUND: METHODS: We performed a retrospective multicenter data analysis of patients with decompensated HCV cirrhosis (MELD ≥15) that presented to liver transplant centers that are part of the German Center for Infection Research when highly active DAA therapy was available. Choice of treatment strategy (DAA first vs. transplantation first) was analyzed and correlated with baseline and outcome parameters. RESULTS: Thirty-five patients fulfilled the inclusion criteria and their mean MELD score was 18.5±3.78 (median: 17, interquartile range=16-19). In the majority of patients (85.7%) DAA therapy was initiated before LT; survival rates and change in MELD were numerically better in this group compared with those where DAA therapy was withheld (82.1 vs. 40%, P=0.078; ΔMELD: -2.68±6.2 vs. 5.8±14.4, P=0.157). However, DAA treatment was more often initiated in patients with better liver function (MELD: 18±3.54 vs. 21.8±3.9, P=0.008). Three patients discontinued DAA treatment because of clinical deterioration; these patients all had a MELD score above 20 at the start of therapy. CONCLUSION: At liver transplant centers in Germany DAA before LT is attempted in the majority of cases. It appears to be associated with an improved outcome and seems safe at least in individuals with MELD below or equal to 20.
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Authors | Lisa Sandmann, Petra Dörge, Anika Wranke, Johannes Vermehren, Tania M Welzel, Christoph P Berg, Julia M Grottenthaler, Karl-Heinz Weiss, Jessica Langel, Martina Sterneck, Moritz von Wulffen, Michael P Manns, Heiner Wedemeyer, Svenja Hardtke, Thomas von Hahn |
Journal | European journal of gastroenterology & hepatology
(Eur J Gastroenterol Hepatol)
Vol. 31
Issue 8
Pg. 1049-1056
(Aug 2019)
ISSN: 1473-5687 [Electronic] England |
PMID | 30807443
(Publication Type: Journal Article, Multicenter Study)
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Chemical References |
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Topics |
- Adolescent
- Adult
- Aged
- Antiviral Agents
(therapeutic use)
- Female
- Follow-Up Studies
- Germany
(epidemiology)
- Hepatitis C, Chronic
(complications, drug therapy)
- Humans
- Incidence
- Liver Cirrhosis
(epidemiology, etiology, surgery)
- Liver Transplantation
- Male
- Middle Aged
- Prognosis
- Retrospective Studies
- Young Adult
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