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Residual Hepatic HCV-RNA in the Native Liver of Living Donor Liver Transplant Recipients with Chronic Hepatitis C: Mini-Review

Shu Hsien Lin, Chih Chi Wang, Kuang Tzu Huang, Kuang Den Chen, Chih Che Lin, Li Wen Hsu and King Wah Chiu

Chronic Hepatitis C Virus (HCV) infection is the leading risk factor for Hepatocellular Carcinoma (HCC), with an annual HCC risk of 2%-4% in cirrhotic patients. With the highly effective and safe direct-acting antiviral (DAA) therapy, HCV infection would be considered “cured and eliminated” successfully in >95% treated patients. However, even with the widespread use of direct-acting antivirals, Living Donor Liver Transplantation (LDLT) plays an important role in advanced liver disease. According to our recent observation, the pre-transplant serum HCV RNA levels may give an underestimate of the number of positive HCV RNA cases and that hepatic HCV RNA data may be more accurate.

Herein, we would like to have a mini review to detailed address issues including the significance of hepatic HCV RNA and the discrepancy between hepatic HCV RNA and HCV core antigen in native liver of chronic hepatitis C recipients undergoing LDLT, a new insight into cure and complete elimination of HCV infection and the utilization of HCV-aviremic organs into aviremic recipients in liver transplantation.