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Impact of #DAAs on liver #transplantation: major effects on the evolution of indications and results. An ELITA study based on the ELTR registry
https://www.journal-of-hepatology.eu/article/S0168-8278(18)32163-9/fulltext
Out of a total number of 60,527 LTs, 36,382 were performed in patients with HCV, HBV, ETOH and NASH. The percentage of LTs due to HCV-related liver disease varied significantly over time (p<0.0001), decreasing from 22.8% in IFN/RBV era to 17.4% in the DAA era, while those performed for NASH increased significantly (p<0.0001). In the DAA era, the percentage of LTs for HCV decreased significantly (p<0.0001) from 21.1% (first semester 2014) to 10.6% (first semester 2017). This decline was more evident in patients with DC (HCV-DC, -58.0%) than in those with HCC associated to HCV (HCV-HCC, -41.2%). Conversely, three-year survival of LT recipients with HCV related liver disease improved from 65.1% in the IFN/RBV era to 76.9% in the DAA era, being currently comparable to the survival of recipients with HBV infection (p=0.3807).
Conclusions
In Europe, the number of LTs due to HCV infection is rapidly declining for both HCV-DC and HCV-HCC indications and post-LT survival has dramatically improved over the last three years. This is the first comprehensive study of the overall impact of DAA treatment for HCV on liver transplantation in Europe.
Impact of #DAAs on liver #transplantation: major effects on the evolution of indications and results. An ELITA study based on the ELTR registry
https://www.journal-of-hepatology.eu/article/S0168-8278(18)32163-9/fulltext
Out of a total number of 60,527 LTs, 36,382 were performed in patients with HCV, HBV, ETOH and NASH. The percentage of LTs due to HCV-related liver disease varied significantly over time (p<0.0001), decreasing from 22.8% in IFN/RBV era to 17.4% in the DAA era, while those performed for NASH increased significantly (p<0.0001). In the DAA era, the percentage of LTs for HCV decreased significantly (p<0.0001) from 21.1% (first semester 2014) to 10.6% (first semester 2017). This decline was more evident in patients with DC (HCV-DC, -58.0%) than in those with HCC associated to HCV (HCV-HCC, -41.2%). Conversely, three-year survival of LT recipients with HCV related liver disease improved from 65.1% in the IFN/RBV era to 76.9% in the DAA era, being currently comparable to the survival of recipients with HBV infection (p=0.3807).
Conclusions
In Europe, the number of LTs due to HCV infection is rapidly declining for both HCV-DC and HCV-HCC indications and post-LT survival has dramatically improved over the last three years. This is the first comprehensive study of the overall impact of DAA treatment for HCV on liver transplantation in Europe.