Published online Mar 27, 2021. doi: 10.4254/wjh.v13.i3.291
Peer-review started: November 16, 2020
First decision: January 18, 2021
Revised: January 20, 2021
Accepted: March 11, 2021
Article in press: March 11, 2021
Published online: March 27, 2021
Core Tip: Hepatitis D virus (HDV) is a dependent virus and relies on hepatitis B virus (HBV) to synthesize the pathogenic genomes. Therefore, it can only survive as a coinfection with HBV or as a superinfection. Chronic HDV infection results in rapid liver damage and can result in end stage liver disease. Currently, pegylated interferon alpha is the only approved therapy for chronic HDV infection and is associated with significant side effects. Thus, liver transplant remains the only option for patients with end-stage liver disease, hepatocellular carcinoma due to coinfection or superinfection with HDV and HBV, fulminant liver failure and those who cannot be treated with interferon-based therapies. Post transplantation reinfection with HDV/HBV is an undesirable outcome. Though, there is a consensus that hepatitis B immune globulin in combination with a potent nucleoside/nucleotide analogue have shown promising results. In addition, there is ongoing research for newer treatment drugs. This review article focuses on liver transplant in patients as a result of hepatitis D virus. We have discussed the epidemiology, pathogenesis, clinical presentation, indication of liver transplantation, treatment options and the outcomes. New therapy trials have been also discussed in the treatment section. We believe that this topic is an area of knowledge gap and this article will cover the basics.