95% of respondents stated that they would use a liver from an HCV-positive donor for an HCV-positive recipient, and 93% would re-transplant a patient with graft failure due to hepatitis C, although most respondents would not re-transplant a patient less than one year after initial GSI-IX transplant. 62% used an alternative immunosuppression strategy in HCV-infected patients, most commonly a smaller post-operative steroid bolus and a rapid steroid taper. 64% preferred
tacrolimus to cyclosporine for immunosuppression in patients with hepatitis C. 87% performed protocol biopsies at specific time points after transplantation. The trigger to treat HCV was > stage 2 (Metavir) fibrosis (97%), cholestatic hepatitis C (81%), and increased liver enzymes (19%). Treatment included antiviral therapy (97%), discontinuing or decreasing the prednisone and mycophenolate doses (35 and 32% respectively), and conversion from tacrolimus to cyclosporine (30%). Post transplant anti-viral therapies included a protease inhibitor/peg/riba (72%) and peg/riba (28%). Regarding use of sofosbuvir (sof) or simeprevir (sim) pre-transplantation, 62% of respondents would use sof/riba, 32% sof/peg/riba and 8% sim/peg/riba pre-transplant in a patient with genotype-1 infection. Related to all-oral HCV treatment regimens; 78% would use such a regimen; 51% pre-transplant,
selleck compound 19% immediately post-transplant and 30% in patients with clinically significant HCV recurrence in the graft. Conclusions: Pre- and post-transplantation management of hepatitis C varies significantly. Respondents appear willing to use both recently FDA-approved and future interferon-free
therapies to reduce HCV replication pre-and post-transplantation. Disclosures: Paul J. Gaglio – Advisory Committees or Review Panels: Merck, Vertex, Salix, BI, BMS, Janssen; Grant/Research Support: Merck, Gilead, Vertex, Otsuka, Genentech, MCE BI; Speaking and Teaching: Merck, Gilead, Vertex, Salix, Otsuka, Janssen The following people have nothing to disclose: Carly E. Glick, John F. Reinus BACKGROUND: End-stage liver disease caused by hepatitis C virus (HCV) is a leading indication (40%) for liver transplantation (LT) in Western Countries. Viral recurrence in the graft is considered “universal” and represents a major cause of mortality and morbidity after LT. METHODS: We retrospectively analyzed data from the last 14 years regarding patients with HCV-related liver disease who underwent LT in our Centre showing undetectable HCV-RNA at blood tests. We looked for pre-LT predictors of HCV recurrences (both histological and virological) and we conducted grafts and patients follow-up until April 2014. RESULTS: 50 patients were included in the study, 22/50 (44%) being HBV-HCV co-infected. We observed HCV-RNA recurrence in 8/50 (16%) patients, and histological recurrence at liver biopsy in 6/50 (12%).