Acute liver graft cellular rejection after interferon-free antiviral treatment for HCV infection. Is there a risk? A warning about three cases.

IF 1.5 4区 医学 Q2 Medicine Acta Gastro-Enterologica Belgica Pub Date : 2019-01-01
G Dahlqvist, Y Horsmans, M Komuta, L Coubeau
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引用次数: 0

Abstract

All patients transplanted for hepatitis C (HCV)- related cirrhosis will experience a recurrence of the viral disease on the liver graft with an accelerated course of the disease and a progression to advanced liver fibrosis in up to 50% of the patients at 5 years post-liver transplantation. HCV infection is a high risk for graft lost. We report here three cases of patients transplanted for hepatocellular carcinoma on HCV-related cirrhosis. All cases experienced an acute cellular rejection after the end of HCV therapy with direct acting antivirals (DAAs). We thus advocate for a close monitoring of tacrolimus and liver tests even a few months after the end of the treatment. Clinicians using DAAs after liver transplantation should be aware of the dynamics of tacrolimus levels during therapy and immunological changes that can occur even several weeks (or months) after the end of DAA treatment.

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无干扰素抗病毒治疗HCV感染后急性肝移植细胞排斥反应。有风险吗?关于三种情况的警告。
所有因丙型肝炎(HCV)相关肝硬化而接受肝移植的患者,在肝移植后5年,将经历肝移植上的病毒性疾病复发,病程加快,并在高达50%的患者中进展为晚期肝纤维化。丙型肝炎病毒感染是移植物丢失的高风险。我们在此报告三例肝细胞癌移植患者的丙型肝炎相关肝硬化。所有病例在直接抗病毒药物(DAAs)治疗HCV结束后均出现急性细胞排斥反应。因此,我们提倡密切监测他克莫司并在治疗结束几个月后进行肝脏检查。肝移植后使用DAA的临床医生应注意治疗期间他克莫司水平的动态变化,以及DAA治疗结束后几周(或几个月)可能发生的免疫变化。
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来源期刊
Acta Gastro-Enterologica Belgica
Acta Gastro-Enterologica Belgica 医学-胃肠肝病学
CiteScore
2.80
自引率
20.00%
发文量
0
审稿时长
>12 weeks
期刊介绍: The Journal Acta Gastro-Enterologica Belgica principally publishes peer-reviewed original manuscripts, reviews, letters to editors, book reviews and guidelines in the field of clinical Gastroenterology and Hepatology, including digestive oncology, digestive pathology, as well as nutrition. Pure animal or in vitro work will not be considered for publication in the Journal. Translational research papers (including sections of animal or in vitro work) are considered by the Journal if they have a clear relationship to or relevance for clinical hepato-gastroenterology (screening, disease mechanisms and/or new therapies). Case reports and clinical images will be accepted if they represent an important contribution to the description, the pathogenesis or the treatment of a specific gastroenterology or liver problem. The language of the Journal is English. Papers from any country will be considered for publication. Manuscripts submitted to the Journal should not have been published previously (in English or any other language), nor should they be under consideration for publication elsewhere. Unsolicited papers are peer-reviewed before it is decided whether they should be accepted, rejected, or returned for revision. Manuscripts that do not meet the presentation criteria (as indicated below) will be returned to the authors. Papers that go too far beyond the scope of the journal will be also returned to the authors by the editorial board generally within 2 weeks. The Journal reserves the right to edit the language of papers accepted for publication for clarity and correctness, and to make formal changes to ensure compliance with AGEB’s style. Authors have the opportunity to review such changes in the proofs.
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