Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 21, 2015; 21(19): 5768-5777
Published online May 21, 2015. doi: 10.3748/wjg.v21.i19.5768
Hepatitis C: New challenges in liver transplantation
Tajana Filipec Kanizaj, Nino Kunac
Tajana Filipec Kanizaj, Department of Gastroenterology, University Hospital Merkur, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Nino Kunac, University Hospital Merkur, 10000 Zagreb, Croatia
Author contributions: Filipec Kanizaj T designed the study and was the primary author of this paper; Kunac N completed the literature review and contributed to the writing, design and revision of the paper.
Conflict-of-interest: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Tajana Filipec Kanizaj, PhD, Associate Professor, Department of Gastroenterology, University Hospital Merkur, School of Medicine, University of Zagreb, Zajceva 19, 10000 Zagreb, Croatia. tajana_filipec@yahoo.com
Telephone: +38-598-623903 Fax: +38-512-431393
Received: November 28, 2014
Peer-review started: November 28, 2014
First decision: January 22, 2015
Revised: February 28, 2015
Accepted: April 17, 2015
Article in press: April 17, 2015
Published online: May 21, 2015
Abstract

In an era of great achievements in liver transplantation, hepatitis C viral infection (HCV) remains an unsolved problem. As a leading indication for liver transplantation in Western countries, HCV poses a significant burden both before and after transplantation. Post-transplant disease recurrence occurs in nearly all patients with detectable pretransplant viremia, compromising the lifesaving significance of transplantation. Many factors involving the donor, recipient and virus have been evaluated throughout the literature, although few have been fully elucidated and implemented in actual clinical practice. Antiviral therapy has been recognized as a cornerstone of HCV infection control; however, experience and success are diminished following transplantation in a challenging cohort of patients with liver cirrhosis. Current therapeutic protocols surpass those used previously, both in sustained viral response and side-effect profile. In this article we review the most relevant and contemporary scientific evidence regarding hepatitis C infection and liver transplantation, with special attention dedicated to novel, more efficient and safer antiviral regimens.

Keywords: Hepatitis C, Liver transplantation, Treatment protocols, Pegylated interferon, Ribavirin, Direct acting antivirals

Core tip: Extensive and revolutionary new data are currently emerging in the field of hepatitis C viral (HCV) treatment. Knowledge is changing faster than ever, although the treatment of HCV infection remains the most challenging problem in transplantation. In this article we report new insights into the actual knowledge of treatment opportunities in the pre- and post-transplant periods.