BACKGROUND & AIMS Antiviral therapy for the treatment of hepatitis C (HCV) infection has proved to be safe and efficacious in patients with cirrhosis awaiting liver transplantation (LT). However, the information regarding the clinical impact of viral eradication in patients on the waiting list is still limited. The aim of the study was to investigate the probability of delisting in patients who underwent antiviral therapy, and the clinical outcomes of these delisted patients. METHODS Observational, multicenter and retrospective analysis was carried out on prospectively collected data from patients positive for HCV, treated with an interferon-free regimen, while awaiting LT in 18 hospitals in Spain. RESULTS In total, 238 patients were enrolled in the study. The indication for LT was decompensated cirrhosis (with or without hepatocellular carcinoma [HCC]) in 171 (72%) patients, and HCC in 67 (28%) patients. Sustained virologic response (SVR) rate was significantly higher in patients with compensated cirrhosis and HCC (92% vs. 83% in patients with decompensated cirrhosis with or without HCC, p=0.042). Among 122 patients with decompensated cirrhosis without HCC, 29 (24%) were delisted due to improvement. No patient with baseline MELD score >20 was delisted. After delisting (median follow-up of 88weeks), three patients had clinical decompensations and three had de novo HCC. Only two of the patients with HCC had to be re-admitted onto the waiting list. The remaining 23 patients remained stable, with no indication for LT. CONCLUSIONS Antiviral therapy is safe and efficacious in patients awaiting LT. A quarter of patients with decompensated cirrhosis can be delisted asa result of clinical improvement, which appears to be remain stable in most patients. Thus, delisting is a safe strategy that could spare organs and benefit other patients with a more urgent need. LAY SUMMARY Antiviral therapy in patients awaiting liver transplantation is safe and efficacious. Viral eradication allows removal from the waiting list of a quarter of treated patients. Delisting because of clinical improvement is a safe strategy that can spare organs for patients in urgent need.

中文翻译：

---

等待肝移植期间接受抗病毒治疗的患者的临床结果

背景和目的 治疗丙型肝炎 (HCV) 感染的抗病毒疗法已被证明对等待肝移植 (LT) 的肝硬化患者是安全有效的。然而，关于病毒根除对等待名单上的患者的临床影响的信息仍然有限。该研究的目的是调查接受抗病毒治疗的患者退市的可能性，以及这些退市患者的临床结果。方法 对西班牙 18 家医院在等待 LT 期间接受无干扰素方案治疗的 HCV 阳性患者的前瞻性收集数据进行了观察性、多中心和回顾性分析。结果 总共有 238 名患者参加了这项研究。LT 的适应症为 171 名 (72%) 患者的失代偿性肝硬化（伴或不伴肝细胞癌 [HCC]）和 67 名 (28%) 患者的 HCC。代偿期肝硬化和 HCC 患者的持续病毒学应答 (SVR) 率显着更高（92% 对伴或不伴 HCC 的失代偿肝硬化患者为 83%，p=0.042）。在 122 名无 HCC 的失代偿性肝硬化患者中，29 名（24%）因病情好转而被除名。没有基线 MELD 评分 >20 的患者被除名。退市后（中位随访 88 周），三名患者出现临床失代偿，三名患者出现新发 HCC。只有两名 HCC 患者必须重新进入等候名单。其余 23 名患者保持稳定，无 LT 指征。结论 对于等待 LT 的患者，抗病毒治疗是安全有效的。由于临床改善，四分之一的失代偿性肝硬化患者可以被除名，这在大多数患者中似乎保持稳定。因此，除名是一种安全的策略，可以保留器官并使其他有更紧迫需求的患者受益。临床总结 等待肝移植患者的抗病毒治疗是安全有效的。病毒根除允许从四分之一接受治疗的患者的等候名单中删除。因临床改善而退市是一种安全的策略，可以为急需的患者保留器官。临床总结 等待肝移植患者的抗病毒治疗是安全有效的。病毒根除允许从四分之一接受治疗的患者的等候名单中删除。因临床改善而退市是一种安全的策略，可以为急需的患者保留器官。临床总结 等待肝移植患者的抗病毒治疗是安全有效的。病毒根除允许从四分之一接受治疗的患者的等候名单中删除。因临床改善而退市是一种安全的策略，可以为急需的患者保留器官。