Hepatitis D virus(HDV)is a dependent virus that relies on hepatitis B virus for its replication and transmission.Chronic hepatitis D is a severe form of viral hepatitis that can result in end stage liver disease.Curre...Hepatitis D virus(HDV)is a dependent virus that relies on hepatitis B virus for its replication and transmission.Chronic hepatitis D is a severe form of viral hepatitis that can result in end stage liver disease.Currently,pegylated interferon alpha is the only approved therapy for chronic HDV infection and is associated with significant side effects.Liver transplantation(LT)is the only treatment option for patients with end-stage liver disease,hepatocellular carcinoma,or fulminant hepatitis due to coinfection with HDV.As LT for HDV and hepatitis B virus coinfection is uncommon in the United States,most data on the long-term impact of LT on HDV are from international centers.In this review,we discuss the indications and results of LT with treatment options in HDV patients.展开更多
Hepatocellular carcinoma(HCC)is one of the leading causes of cancer deaths worldwide and liver transplantation(LT)is the only potentially curative treatment.Over the years,Milan criteria has been used for patient sele...Hepatocellular carcinoma(HCC)is one of the leading causes of cancer deaths worldwide and liver transplantation(LT)is the only potentially curative treatment.Over the years,Milan criteria has been used for patient selection.There is ongoing research in this field with introduction of new biomarkers for HCC that can help guide future treatment.Furthermore,newer therapies for downstaging of the tumor are being implemented to prevent dropout from the transplant list.In addition,combination therapies for better outcome are under investigation.Interestingly,the concept of living-donor LT and possible use of hepatitis C virus-positive donors has been implemented as an attempt to expand the organ pool.However,there is a conflict of opinion between different centers regarding its efficacy and data is scarce.The aim of this review article is to outline the various selection criteria for LT,discuss the outcomes of LT in HCC patients,and explore future directions of LT for HCC.Therefore,a comprehensive PubMed/MEDLINE review was conducted.To expand our search,references of the retrieved articles were also screened for additional data.After selecting the studies,the authors independently reviewed them to identify the relevant studies.After careful evaluation 120 studies relevant to out topic are cited in the manuscript.Three tables and two figures are also included.In conclusion LT for HCC has evolved over the years.With the introduction of several expanded criteria beyond Milan,the introduction of bridging therapies,such as transcatheter arterial chemoembolization and radiofrequency ablation,and the approval of newer systemic therapies,it is evident that there will be more LT recipients in the future.It is promising to see ongoing trials and the continuous evolution of protocols.Prospective studies are needed to guide the development of a pre-LT criteria that can ensure low HCC recurrence risk and is not overly stringent,clarify the role of LDLT,and determine the optimal bridging therapies to LT.展开更多
文摘Hepatitis D virus(HDV)is a dependent virus that relies on hepatitis B virus for its replication and transmission.Chronic hepatitis D is a severe form of viral hepatitis that can result in end stage liver disease.Currently,pegylated interferon alpha is the only approved therapy for chronic HDV infection and is associated with significant side effects.Liver transplantation(LT)is the only treatment option for patients with end-stage liver disease,hepatocellular carcinoma,or fulminant hepatitis due to coinfection with HDV.As LT for HDV and hepatitis B virus coinfection is uncommon in the United States,most data on the long-term impact of LT on HDV are from international centers.In this review,we discuss the indications and results of LT with treatment options in HDV patients.
文摘Hepatocellular carcinoma(HCC)is one of the leading causes of cancer deaths worldwide and liver transplantation(LT)is the only potentially curative treatment.Over the years,Milan criteria has been used for patient selection.There is ongoing research in this field with introduction of new biomarkers for HCC that can help guide future treatment.Furthermore,newer therapies for downstaging of the tumor are being implemented to prevent dropout from the transplant list.In addition,combination therapies for better outcome are under investigation.Interestingly,the concept of living-donor LT and possible use of hepatitis C virus-positive donors has been implemented as an attempt to expand the organ pool.However,there is a conflict of opinion between different centers regarding its efficacy and data is scarce.The aim of this review article is to outline the various selection criteria for LT,discuss the outcomes of LT in HCC patients,and explore future directions of LT for HCC.Therefore,a comprehensive PubMed/MEDLINE review was conducted.To expand our search,references of the retrieved articles were also screened for additional data.After selecting the studies,the authors independently reviewed them to identify the relevant studies.After careful evaluation 120 studies relevant to out topic are cited in the manuscript.Three tables and two figures are also included.In conclusion LT for HCC has evolved over the years.With the introduction of several expanded criteria beyond Milan,the introduction of bridging therapies,such as transcatheter arterial chemoembolization and radiofrequency ablation,and the approval of newer systemic therapies,it is evident that there will be more LT recipients in the future.It is promising to see ongoing trials and the continuous evolution of protocols.Prospective studies are needed to guide the development of a pre-LT criteria that can ensure low HCC recurrence risk and is not overly stringent,clarify the role of LDLT,and determine the optimal bridging therapies to LT.
