BACKGROUND AND AIMS: Hepatitis C virus (HCV)-viremic organs are underutilized, and there is limited real-world experience on the transplantation of HCV-viremic solid organs into recipients who are HCV negative. APPROACH AND RESULTS: Patients listed or being evaluated for solid organ transplant after January 26, 2018, were educated and consented by protocol on the transplantation of HCV-viremic organs. All recipients were HCV nucleic acid test and anti-HCV antibody negative at the time of transplant and received an HCV-viremic organ. The primary outcome was sustained virological response (SVR) at 12 weeks after completion of direct-acting antiviral (DAA) therapy (SVR12 ). Seventy-seven patients who were HCV negative underwent solid organ transplantation from a donor who was HCV viremic. No patients had evidence of advanced hepatic fibrosis. Treatment regimen and duration were at the discretion of the hepatologist. Sixty-four patients underwent kidney transplant (KT), and 58 KT recipients had either started or completed DAA therapy. Forty-one achieved SVR12 , 10 had undetectable viral loads but are not eligible for SVR12 , and 7 remain on treatment. One KT recipient was a nonresponder because of nonstructural protein 5A resistance. Four patients underwent liver transplant and 2 underwent liver-kidney transplant. Three patients achieved SVR12 , 1 has completed DAA therapy, and 2 remain on treatment. Six patients underwent heart transplant and 1 underwent heart-kidney transplant. Six patients achieved SVR12 and 1 patient remains on treatment. CONCLUSIONS: Limited data exist on the transplantation of HCV-viremic organs into recipients who are HCV negative. Our study is the largest to describe a real-world experience of the transplantation of HCV-viremic organs into recipients who are aviremic. In carefully selected patients, the use of HCV-viremic grafts in the DAA era appears to be efficacious and well tolerated.
BACKGROUND AND AIMS: Hepatitis C virus (HCV)-viremic organs are underutilized, and there is limited real-world experience on the transplantation of HCV-viremic solid organs into recipients who are HCV negative. APPROACH AND RESULTS:Patients listed or being evaluated for solid organ transplant after January 26, 2018, were educated and consented by protocol on the transplantation of HCV-viremic organs. All recipients were HCV nucleic acid test and anti-HCV antibody negative at the time of transplant and received an HCV-viremic organ. The primary outcome was sustained virological response (SVR) at 12 weeks after completion of direct-acting antiviral (DAA) therapy (SVR12 ). Seventy-seven patients who were HCV negative underwent solid organ transplantation from a donor who was HCV viremic. No patients had evidence of advanced hepatic fibrosis. Treatment regimen and duration were at the discretion of the hepatologist. Sixty-four patients underwent kidney transplant (KT), and 58 KT recipients had either started or completed DAA therapy. Forty-one achieved SVR12 , 10 had undetectable viral loads but are not eligible for SVR12 , and 7 remain on treatment. One KT recipient was a nonresponder because of nonstructural protein 5A resistance. Four patients underwent liver transplant and 2 underwent liver-kidney transplant. Three patients achieved SVR12 , 1 has completed DAA therapy, and 2 remain on treatment. Six patients underwent heart transplant and 1 underwent heart-kidney transplant. Six patients achieved SVR12 and 1 patient remains on treatment. CONCLUSIONS: Limited data exist on the transplantation of HCV-viremic organs into recipients who are HCV negative. Our study is the largest to describe a real-world experience of the transplantation of HCV-viremic organs into recipients who are aviremic. In carefully selected patients, the use of HCV-viremic grafts in the DAA era appears to be efficacious and well tolerated.
Authors: Krista L Lentine; John D Peipert; Tarek Alhamad; Yasar Caliskan; Beatrice P Concepcion; Rachel Forbes; Mark Schnitzler; Su-Hsin Chang; Matthew Cooper; Roy D Bloom; Roslyn B Mannon; David A Axelrod Journal: Kidney360 Date: 2020-11-25
Authors: Miklos Z Molnar; Vishnu S Potluri; Douglas E Schaubel; Meghan E Sise; Beatrice P Concepcion; Rachel C Forbes; Emily Blumberg; Roy D Bloom; David Shaffer; Raymond T Chung; Ian A Strohbehn; Nahel Elias; Ambreen Azhar; Mital Shah; Deirdre Sawinski; Laura A Binari; Manish Talwar; Vasanthi Balaraman; Anshul Bhalla; James D Eason; Behdad Besharatian; Jennifer Trofe-Clark; David S Goldberg; Peter P Reese Journal: Am J Transplant Date: 2021-10-06 Impact factor: 8.086
Authors: Emily Bethea; Ashwini Arvind; Jenna Gustafson; Karin Andersson; Daniel Pratt; Irun Bhan; Michael Thiim; Kathleen Corey; Patricia Bloom; Jim Markmann; Heidi Yeh; Nahel Elias; Shoko Kimura; Leigh Anne Dageforde; Alex Cuenca; Tatsuo Kawai; Kassem Safa; Winfred Williams; Hannah Gilligan; Meghan Sise; Jay Fishman; Camille Kotton; Arthur Kim; Christin C Rogers; Sarah Shao; Mariesa Cote; Linda Irwin; Paul Myoung; Raymond T Chung Journal: Am J Transplant Date: 2020-02-03 Impact factor: 8.086
Authors: Meghan E Sise; David S Goldberg; Jens J Kort; Douglas E Schaubel; Rita R Alloway; Christine M Durand; Robert J Fontana; Robert S Brown; John J Friedewald; Stacey Prenner; J Richard Landis; Melissa Fernando; Caitlin C Phillips; E Steve Woodle; Adele Rike-Shields; Kenneth E Sherman; Nahel Elias; Winfred W Williams; Jenna L Gustafson; Niraj M Desai; Brittany Barnaba; Silas P Norman; Mona Doshi; Samuel T Sultan; Meredith J Aull; Josh Levitsky; Dianne S Belshe; Raymond T Chung; Peter P Reese Journal: J Am Soc Nephrol Date: 2020-08-25 Impact factor: 10.121
Authors: Christine M Durand; Brittany Barnaba; Sile Yu; Diane M Brown; Michael A Chattergoon; Nichole Bair; Fizza F Naqvi; Mark Sulkowski; Dorry L Segev; Niraj M Desai Journal: Ann Intern Med Date: 2020-09-08 Impact factor: 25.391
Authors: Su-Hsin Chang; Massini Merzkani; Krista L Lentine; Mei Wang; David A Axelrod; Siddiq Anwar; Mark A Schnitzler; Jason Wellen; William C Chapman; Tarek Alhamad Journal: Clin J Am Soc Nephrol Date: 2021-01-15 Impact factor: 8.237