Optimal Timing of Administration of Direct-Acting Antivirals for Patients with Hepatitis C-Associated Hepatocellular Carcinoma Undergoing Liver Transplantation
dc.contributor.author | Turgeon, Michael K. | |
dc.contributor.author | Shah, Shimul A. | |
dc.contributor.author | Delman, Aaron M. | |
dc.contributor.author | Tran, Benjamin V. | |
dc.contributor.author | Agopian, Vatche G. | |
dc.contributor.author | Wedd, Joel P. | |
dc.contributor.author | Magliocca, Joseph F. | |
dc.contributor.author | Kim, Ahyoung | |
dc.contributor.author | Cameron, Andrew | |
dc.contributor.author | Olyaei, Ali | |
dc.contributor.author | Orloff, Susan L. | |
dc.contributor.author | Anderson, Matthew P. | |
dc.contributor.author | Kubal, Chandrashekhar A. | |
dc.contributor.author | Cannon, Robert M. | |
dc.contributor.author | Locke, Jayme E. | |
dc.contributor.author | Simpson, Mary A. | |
dc.contributor.author | Akoad, Mohamed E. | |
dc.contributor.author | Wongjirad, Chelsey P. | |
dc.contributor.author | Emamaullee, Juliet | |
dc.contributor.author | Moro, Amika | |
dc.contributor.author | Aucejo, Federico | |
dc.contributor.author | Feizpour, Cyrus A. | |
dc.contributor.author | Vagefi, Parsia A. | |
dc.contributor.author | Nguyen, Mindie H. | |
dc.contributor.author | Esquivel, Carlos O. | |
dc.contributor.author | Dhanireddy, Kiran | |
dc.contributor.author | Subramanian, Vijay | |
dc.contributor.author | Chavarriaga, Alejandro | |
dc.contributor.author | Kazimi, Marwan M. | |
dc.contributor.author | Anderson, Maia S. | |
dc.contributor.author | Sonnenday, Christopher J. | |
dc.contributor.author | Kim, Steven C. | |
dc.contributor.author | Foley, David P. | |
dc.contributor.author | Abdouljoud, Marwan | |
dc.contributor.author | Salgia, Reena J. | |
dc.contributor.author | Moris, Dimitrios | |
dc.contributor.author | Sudan, Debra L. | |
dc.contributor.author | Ganesh, Swaytha R. | |
dc.contributor.author | Humar, Abhinav | |
dc.contributor.author | Doyle, Majella | |
dc.contributor.author | Chapman, William C. | |
dc.contributor.author | Maithel, Shishir K. | |
dc.contributor.department | Surgery, School of Medicine | en_US |
dc.date.accessioned | 2022-01-27T15:31:50Z | |
dc.date.available | 2022-01-27T15:31:50Z | |
dc.date.issued | 2021-10 | |
dc.description.abstract | Objective: To investigate the optimal timing of direct acting antiviral (DAA) administration in patients with hepatitis C-associated hepatocellular carcinoma (HCC) undergoing liver transplantation (LT). Summary of Background Data: In patients with hepatitis C (HCV) associated HCC undergoing LT, the optimal timing of direct-acting antivirals (DAA) administration to achieve sustained virologic response (SVR) and improved oncologic outcomes remains a topic of much debate. Methods: The United States HCC LT Consortium (2015–2019) was reviewed for patients with primary HCV-associated HCC who underwent LT and received DAA therapy at 20 institutions. Primary outcomes were SVR and HCC recurrence-free survival (RFS). Results: Of 857 patients, 725 were within Milan criteria. SVR was associated with improved 5-year RFS (92% vs 77%, P < 0.01). Patients who received DAAs pre-LT, 0–3 months post-LT, and ≥3 months post-LT had SVR rates of 91%, 92%, and 82%, and 5-year RFS of 93%, 94%, and 87%, respectively. Among 427 HCV treatment-naïve patients (no previous interferon therapy), patients who achieved SVR with DAAs had improved 5-year RFS (93% vs 76%, P < 0.01). Patients who received DAAs pre-LT, 0–3 months post-LT, and ≥3 months post-LT had SVR rates of 91%, 93%, and 78% (P < 0.01) and 5-year RFS of 93%, 100%, and 83% (P = 0.01). Conclusions: The optimal timing of DAA therapy appears to be 0 to 3 months after LT for HCV-associated HCC, given increased rates of SVR and improved RFS. Delayed administration after transplant should be avoided. A prospective randomized controlled trial is warranted to validate these results. | en_US |
dc.eprint.version | Author's manuscript | en_US |
dc.identifier.citation | Turgeon, M. K., Shah, S. A., Delman, A. M., Tran, B. V., Agopian, V. G., Wedd, J. P., Magliocca, J. F., Kim, A., Cameron, A., Olyaei, A., Orloff, S. L., Anderson, M. P., Kubal, C. A., Cannon, R. M., Locke, J. E., Simpson, M. A., Akoad, M. E., Wongjirad, C. P., Emamaullee, J., … Maithel, S. K. (2021). Optimal Timing of Administration of Direct-Acting Antivirals for Patients with Hepatitis C-Associated Hepatocellular Carcinoma Undergoing Liver Transplantation. Annals of Surgery, 274(4), 613-620. https://doi.org/10.1097/SLA.0000000000005070 | en_US |
dc.identifier.issn | 0003-4932 | en_US |
dc.identifier.uri | https://hdl.handle.net/1805/27576 | |
dc.language.iso | en_US | en_US |
dc.publisher | Wolters Kluwer | en_US |
dc.relation.isversionof | 10.1097/SLA.0000000000005070 | en_US |
dc.relation.journal | Annals of Surgery | en_US |
dc.rights | Publisher Policy | en_US |
dc.source | Author | en_US |
dc.subject | Hepatitis C | en_US |
dc.subject | hepatocellular carcinoma | en_US |
dc.subject | liver transplantation | en_US |
dc.subject | patients with hepatitis C | en_US |
dc.title | Optimal Timing of Administration of Direct-Acting Antivirals for Patients with Hepatitis C-Associated Hepatocellular Carcinoma Undergoing Liver Transplantation | en_US |
dc.type | Article | en_US |