Review Article Living-Donor Liver Transplantation and Hepatitis C

Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Hepatitis-C-virus- (HCV-) related end-stage cirrhosis is the primary indication for liver transplantation in many countries. Unfortunately, however, HCV is not eliminated by transplantation and gra reinfection is universal, resulting in �brosis, cirrhosis, and �nally gra decompression. In areas with low deceased-donor organ availability like Japan, living-donor liver transplantation (LDLT) is similarly indicated forHCV cirrhosis as deceased-donor liver transplantation (DDLT) inWestern countries and accepted as an established treatment for HCV-cirrhosis, and the results are equivalent to those of DDLT. To prevent gra failure due to recurrent hepatitis C, antiviral treatment with pegylated-interferon and ribavirin is currently considered the most promising regimen with a sustained viral response rate of around 30 % to 35%, although the survival bene�t of this regimen remains to be investigated. In contrast to DDLT, many Japanese LDLT centers have reported modi�ed treatment regimens as best e�orts to secure �rst gra, such as aggressive preemptive antiviral treatment, escalation of dosages, and elongation of treatment duration. 1