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Indications and waiting list priority for deceased donor liver transplantation in HIV/HCV co‐infected hemophilic patients in Japan through contaminated blood product
Author(s) -
Eguchi Susumu,
Egawa Hiroto,
Eguchi Hidetoshi,
Uehira Tomoko,
Endo Tomoyuki,
Genda Takuya,
Shinoda Masahiro,
Hasegawa Kiyoshi,
Shimamura Tsuyoshi,
Tsukada Kunihisa,
Hara Tetsuya,
Nakao Kazuhiko,
Yatsuhashi Hiroshi,
Yotsuyanagi Hiroshi,
Natsuda Koji,
Soyama Akihiko,
Hidaka Masaaki,
Hara Takanobu,
Takatsuki Mitsuhisa
Publication year - 2021
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13686
Subject(s) - medicine , hepatitis c , cirrhosis , christian ministry , liver transplantation , transplantation , blood transfusion , human immunodeficiency virus (hiv) , hepatitis c virus , portal hypertension , blood product , liver disease , intensive care medicine , pediatrics , surgery , family medicine , immunology , virus , philosophy , theology
HIV/HCV co‐infection from blood products for hemophilia has been a social problem in Japan. Liver transplantation (LT) is an important treatment option for hepatic failure and cirrhosis of the liver in co‐infected patients, and appropriate indications for LT, especially organ form deceased donors, are required by society. The aim is to propose priority status for the waiting list for deceased donor (DD) LT in HIV/HCV co‐infected patients in Japan based on medical and scientific considerations. Since 2009, we have been working on the subject in research projects under grants‐in‐aid for health and labour sciences research on AIDS measures provided by the Ministry of Health, Labour and Welfare (the Kanematsu project and Eguchi project). Our research showed that hepatic fibrosis is advanced in HIV/HCV co‐infected Japanese patients, especially those with hemophilia who became infected from blood products at a faster rate than HCV mono‐infected patients. In addition, those patients who developed portal hypertension had a poor prognosis at a young age. The results of our research contributed to increasing the priority score of those patients on the deceased donor liver transplantation (DDLT) waiting list in 2013 and to establishing a scoring system for DDLT corresponding to the Model for End‐stage Liver disease (MELD) score in 2019. This paper introduces changes in priority and the current state of priority of the DDLT waiting list for HIV/HCV co‐infected patients in Japan.