Long-Term Outcome of Liver Transplant Recipients (OLT) With Hepatitis C Recurrence (HCVR) Who Achieved Postoperative Sustained Virologic Response (SVR) After Combination Antiviral Therapy (Rx) With and Without the Use of Telaprevir (TVR): A Single Center Experience

C. Fasola, P. Mantry, J. Weinstein, H. Nazario, A. Mubarak, M. Barnes, A. Habib, A. Mejia, R. Dickerman, S. Cheng.

Liver Institute, Methodist Dallas Medical Center, Dallas, TX.

Meeting: 2015 American Transplant Congress

Abstract number: A195

Keywords: Graft failure, Hepatitis C, Liver transplantation, Recurrence

Session Information

Date: Saturday, May 2, 2015

Session Name: Poster Session A: Liver Transplantation: Viral Hepatitis

Session Time: 5:30pm-7:30pm

Presentation Time: 5:30pm-7:30pm

Location: Exhibit Hall E

Aim: Liver allografts of viremic OLT have a higher risk of failure. Timely intervention is necessary. However, long-term outcome reports, especially using newer agents, is lacking. Methods: In a 10-year period, we compared: 19 OLT Rx, for 12 weeks, with TVR + Pegylated interferons (P-IFN) + Ribavirin (RBV) followed with conventional Rx (C-Rx, P-IFN+RBV) for 12-36 weeks. Controls (n=19) received C-Rx for 48 weeks. Matching done for age, gender, genotype (all 1), race, OLT date, non-responders (NR), SVR, immunosuppression (tacrolimus + Mycophenolic acid) and survival. Rx criteria HCVR histology (bx, stages 0-3, Batts&Ludwig classification). Pre and post Rx bx + annual bx and 3-year minimum follow up. Laboratory tests, graft and OLT survivals analyzed. Statitistics: t-, Chi2-tests. Results: No demographic , survival (matched controls) or laboratory differences found. Of note, 13/19 (68%) in TVR group were OLT NR to previous C-Rx. At 3+ years of follow up, there was significantly more HCVR progression in OLT TVR NR than TVR SVR (p < 0.05). Controls also showed differences in HCVR progression, although NS.

Liver Allograft Stage Changes with HCV Therapy
	Telaprevir + PegIFN +Ribavirin Rx		PegIFN + Ribavirin
	Non Responders	SVR	Non Responders	SVR
	(n = 6)	(n = 13)	(n = 6)	(n = 13)
PreRx Stage	1.5±0.6*	1.7±1.3	2.0±0.9	1.9±0.9
EndRx Stage	2.2±0.8	2.6±1.3	2.8±1.2	2.0±
Last Follow up Stage	2.7±0.8*	2.1±1.4	2.8±1.2	2.0±
PreRx to Last Bx Difference	1.2±0.8**	0.4±0.7**	0.8±1.0	0.2±1.1

t-test: No differences, except * and **.Conclusions: With at least 3 years of follow up, HCV OLT SVR who received TVR triple Rx showed less HCVR progression. This benefit is in addition to the fact that 2/3 of OLT on TVR Rx had previously failed C-Rx. Newer antiviral agents, currently on trial, could show even superior results.

To cite this abstract in AMA style:

Fasola C, Mantry P, Weinstein J, Nazario H, Mubarak A, Barnes M, Habib A, Mejia A, Dickerman R, Cheng S. Long-Term Outcome of Liver Transplant Recipients (OLT) With Hepatitis C Recurrence (HCVR) Who Achieved Postoperative Sustained Virologic Response (SVR) After Combination Antiviral Therapy (Rx) With and Without the Use of Telaprevir (TVR): A Single Center Experience [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/long-term-outcome-of-liver-transplant-recipients-olt-with-hepatitis-c-recurrence-hcvr-who-achieved-postoperative-sustained-virologic-response-svr-after-combination-antiviral-therapy-rx-with-an/. Accessed August 25, 2019.

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