Patients on the liver transplant list with hepatitis C virus (HCV) and decompensated cirrhosis  were more likely to be removed from the list or to need a transplant less as a result of direct-acting antiviral therapy, a new study presented at The International Liver Congress 2016 showed. 

Currently, the only treatment available for decompensated cirrhosis is a liver transplant. For the retrospective study, researchers evaluated 103 liver transplant candidates with decompensated HCV cirrhosis and without hepatocellular carcinoma over a 1-year period. Study patients had been treated with direct-acting antiviral combinations, which are used to treat patients with HCV. 

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Patients that no longer urgently needed a transplant (n=25) showed an average 11% decrease (4 points) in disease severity based on the Model for End-Stage Liver Disease (MELD) score; the MELD score is used to establish disease severity and urgency for a transplant. Moreover, they demonstrated a 20% improvement (3 points) on the Child-Pugh score, another common scale to assess the prognosis of chronic liver diseases. Treatment with direct-acting antivirals may ultimately reduce the number of deaths that occur in patients on the transplant waitlist, study authors suggested. 

“The results of the study are very encouraging, but a word of caution is to be mentioned since it is presently unknown how long the clinical improvement will last,” added the study’s lead author Dr. Luca Belli, from the Niguarda Hospital, Milan, Italy.

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