**7. References**


patient, thus improving associated survival. Generally speaking, it is recommended that a retransplant should be offered to those patients who have a likelihood of 1-year survival of

The cornerstone depends on reducing the number of candidates for retransplantation, identifying those patients who have accelerated recurrence and undertaking energetic

The advent of new drugs for the treatment of HCV infection, as well as polymerase and protease inhibitors, will considerably change the management of HCV infection due to their high antiviral power (Kwo et al, 2009, Hezode C et al, 2009). Around 50% of non-transplant patients who are difficult to treat because of the presence of factors predicting a lack of response have been shown to experience a greater sustained viral response (Aymant et, 2010). In transplanted patients, the increase in efficacy, applicability and tolerance, and the possible interactions with other drugs are as yet unknown and more studies are still

Despite the advances in liver transplantation, the results in patients with HCV infection are not as satisfactory as desired, due mainly to the recurrence of the primary disease and the lack of availability of an efficient prophylactic therapy. Likewise, antiviral therapy still presents important limitations, particularly its poor tolerance, which hinders its use at full doses or for a sufficient duration to achieve an adequate response. The most recommended attitude is to attempt antiviral therapy prior to the transplant, particularly for those patients with maintained liver function, in an attempt to avoid disease progression, though if this is not possible, at least reach transplantation with a negative viraemia. Strict monitoring of the progression of the fibrosis by serial biopsies and/or elastography will enable early identification of those patients who might benefit from antiviral therapy to detain the advance of the disease and thus avoid the possible need for a retransplant. Nevertheless, new therapeutic approaches are required for the treatment of hepatitis C infection that can obviate the need for liver transplantation. For this, the introduction of protease and polymerase inhibitors is opening up hope for the future

Aymant A, Kaufman M, Norah A. Terrault: Management of posttransplant hepatitis C

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at least 55%, which includes patients with a Rosen score <20.5 (Marti et al, 2008).

measures for their management, as well as starting antiviral therapy.

**5. New therapies for HCV** 

required.

**6. Conclusions** 

treatment of this disease.

2000; 32:852-858.

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