CON: Patients With Decompensated Cirrhosis Listed for Liver Transplantation Should Be Treated Posttransplant

Pedersen, Mark; Tarlow, Branden D.; Mufti, Arjmand

doi:10.1002/cld.789

Cited by 3 publications

(1 citation statement)

References 12 publications

(44 reference statements)

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“…Another retrospective, multicenter, Spanish study showed similar results: among 122 patients with decompensated cirrhosis without HCC receiving DAAs, 29 (24%) were removed from the transplant list due to clinical improvement [19]. Some reviews claim that patients with decompensated cirrhosis should be treated in the post transplant setting given that, when they are treated on the wait listing, there is a decreased SVR12 rate, the clinical improvement is not enough to remove many patients from the transplant list and there are serious safety concerns, including rapid deterioration and death [20].…”

Section: Discussionmentioning

confidence: 99%

Predictive Factors of Decompensation and Death in 670 Patients with Hepatitis C Treated with Direct-Acting Antivirals

Gualano¹,

B²,

Ferreiro³

et al. 2020

JJGH

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1.3. Results: SVR12 rate was 95.5%. Decompensation was observed in 39 (5.8%) patients, death in 11 (1.6%). Variables significantly associated with decompensation or deaths were similar: cirrhosis stage, bilirubin, prothrombin activity, MELD or Child-Pugh scores. ROC curve analysis showed that MELD score ≥10 (HR 5.1, 95% CI, 1.9-13.6) and Child-Pugh score ≥7 (HR 4.6, 95% CI, 2.1-10.1) were predictive of decompensation and/or death. Conclusion:DAAs were effective and safe in patients with compensated cirrhosis but further studies in decompensated cirrhosis are needed to better delineate the MELD and/or Child-Pugh scores that ensure a good safety profile or being appropriate for indicating liver transplant instead of antiviral therapy.

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Section: Discussionmentioning

confidence: 99%