The best treatment for people with end-stage liver disease
is liver transplantation
. The donation of liver segments from living relatives, splitting one donated liver between two recipients, new organ allocation policies and, especially, new approaches to liver transplants for people with Hepatitis C virus
. Until recently, Hepatitis C virus infected livers were routinely discarded. But recent studies have shown that people already infected with Hepatitis C virus who receive livers from Hepatitis C positive donors can do as well as if they had received a liver not infected with the virus. This may mean that many more livers will become available for a person with hepatitis C. Liver transplantation does not cure HCV
. The majority of people with hepatitis C who receive liver transplants experience a recurrence of the virus. Those with HCV who receive liver transplants also are at accelerated risk of developing cirrhosis
within five years. Treatment with HCV-fighting medications may help prevent a recurrence of infection or treat recurrent illness that develops after a liver transplant. However, the effectiveness of this type of treatment after a liver transplant is unclear.
The complications of liver transplant are acute graft rejection, vascular thrombosis
, biliary leak or stricture, and infection. These patients are also at increased risk of developing malignancy, which needs to be considered in the evaluation process. Adverse effects of immunosuppressant drugs also may complicate as well.