Alex Reyentovich1, Claudia G Gidea1, Deane Smith2, Bonnie Lonze3, Zachary Kon2, Anthony Fargnoli2, Jennifer Pavone1, Shaline Rao1, Tajinderpal Saraon1, Tyler Lewis4, Yingzhi Qian5, Ira Jacobson6, Nader Moazami2. 1. Division of Cardiology, Department of Medicine, NYU Langone Medical Center, New York, NY, USA. 2. Department of Cardiothoracic Surgery, NYU Langone Medical Center, New York, NY, USA. 3. Department of Renal Transplant Surgery, NYU Langone Medical Center, New York, NY, USA. 4. Department of Pharmacy, NYU Langone Medical Center, New York, NY, USA. 5. Department of Population Health, Biostatistics Division, NYU Langone Medical Center, New York, NY, USA. 6. Department of Gastroenterology, NYU Langone Medical Center, New York, NY, USA.
Abstract
BACKGROUND: The use of direct-acting antivirals (DAA) has expanded transplantation from hepatitis C viremic donors (HCV-VIR). Our team has conducted an open-label, prospective trial to assess outcomes transplanting HCV viremic hearts. Glecaprevir/pibrentasvir (GLE/PIB) was our sole DAA. METHODS: Serial quantitative hepatitis C virus (HCV) RNA PCR was obtained to assess HCV viral titers. Between January 2018 and June 2019, a total of 50 recipients were transplanted. Of these, 22/50 (44%) were from HCV-VIR, the remaining 28 from non-viremic (HCV NON-VIR) donors. An 8-week course of GLE/PIB was initiated at 1 week post-transplant. RESULTS: There was no difference in demographic or clinical parameters between groups. All 22 recipients of HCV-VIR transplants became viremic. GLE/PIB was effective in decreasing viremia to undetectable levels by 6 weeks post-transplant in all patients. The median time to first undetectable HCV quantitative PCR was (4.3 weeks, IQR: 4-5.7 weeks). All patients demonstrated sustained undetectable viral load through 1-year follow-up. There was no difference in survival at one year between HCV NON-VIR 28/28: (100%) vs HCV-VIR 21/22 (95%) recipients. CONCLUSIONS: Our center reports excellent outcomes in transplanting utilizing hearts from HCV-VIR donors. No effect on survival or co-morbidity was found. An 8-week GLE/PIB course was safe and effective when initiated approximately 1 week post-transplant.
BACKGROUND: The use of direct-acting antivirals (DAA) has expanded transplantation from hepatitis C viremic donors (HCV-VIR). Our team has conducted an open-label, prospective trial to assess outcomes transplanting HCV viremic hearts. Glecaprevir/pibrentasvir (GLE/PIB) was our sole DAA. METHODS: Serial quantitative hepatitis C virus (HCV) RNA PCR was obtained to assess HCV viral titers. Between January 2018 and June 2019, a total of 50 recipients were transplanted. Of these, 22/50 (44%) were from HCV-VIR, the remaining 28 from non-viremic (HCV NON-VIR) donors. An 8-week course of GLE/PIB was initiated at 1 week post-transplant. RESULTS: There was no difference in demographic or clinical parameters between groups. All 22 recipients of HCV-VIR transplants became viremic. GLE/PIB was effective in decreasing viremia to undetectable levels by 6 weeks post-transplant in all patients. The median time to first undetectable HCV quantitative PCR was (4.3 weeks, IQR: 4-5.7 weeks). All patients demonstrated sustained undetectable viral load through 1-year follow-up. There was no difference in survival at one year between HCV NON-VIR 28/28: (100%) vs HCV-VIR 21/22 (95%) recipients. CONCLUSIONS: Our center reports excellent outcomes in transplanting utilizing hearts from HCV-VIR donors. No effect on survival or co-morbidity was found. An 8-week GLE/PIB course was safe and effective when initiated approximately 1 week post-transplant.
Authors: Farina M Hanif; Zain Majid; Nasir Hassan Luck; Abbas Ali Tasneem; Syed Muddasir Laeeq; Muhammed Mubarak Journal: World J Hepatol Date: 2022-04-27
Authors: Zoe A Stewart; Jeffrey Stern; Nicole M Ali; Harmit S Kalia; Karen Khalil; Srijana Jonchhe; Elaina P Weldon; Rebecca A Dieter; Tyler C Lewis; Nur Funches; Sudara Crosby; Monique Seow; Jonathan C Berger; Nabil N Dagher; Bruce E Gelb; Anthony C Watkins; Nader Moazami; Deane E Smith; Zachary N Kon; Stephanie H Chang; Alex Reyentovich; Luis F Angel; Robert A Montgomery; Bonnie E Lonze Journal: Transplant Direct Date: 2021-09-07