Use of Hepatitis C Nucleic Acid Test-Positive Liver Allografts in Hepatitis C Virus Seronegative Recipients.

Autor: Anwar N; Digestive Disease Division, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, OH., Kaiser TE; Digestive Disease Division, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, OH., Bari K; Digestive Disease Division, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, OH., Schoech M; Digestive Disease Division, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, OH., Diwan TS; Solid Organ Transplantation, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH., Cuffy MC; Solid Organ Transplantation, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH., Silski L; Digestive Disease Division, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, OH., Quillin RC 3rd; Solid Organ Transplantation, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH., Safdar K; Digestive Disease Division, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, OH., Shah SA; Solid Organ Transplantation, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH.
Jazyk: angličtina
Zdroj: Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society [Liver Transpl] 2020 May; Vol. 26 (5), pp. 673-680.
DOI: 10.1002/lt.25741
Abstrakt: Because of underutilization of liver allografts, our center previously showed that hepatitis C virus (HCV) antibody-positive/nucleic acid test (NAT)-negative livers when transplanted into HCV nonviremic recipients were safe with a 10% risk of HCV transmission. Herein, we present our single-center prospective experience of using HCV NAT+ liver allografts transplanted into HCV NAT- recipients. An institutional review board-approved matched cohort study was conducted examining post- liver transplantation (LT) outcomes of HCV- patients who received HCV NAT+ organs (treatment group) compared with matched recipients with HCV NAT- organs (matched comparator group) between June 2018 to October 2019. The primary endpoint was success of HCV treatment and elimination of HCV infection. The secondary outcomes included the 30-day and 1-year graft and patient survival as well as perioperative complications. There were 32 recipients enrolled into each group. Because of 1 death in the index admission, 30/31 patients (97%) were given HCV treatment at a median starting time of 47 days (18-140 days) after LT. A total of 19 (63%) patients achieved sustained virological response at week 12 (SVR12). Another 6 patients achieved end-of-treatment response, while 5 remained on therapy and 1 is yet to start treatment. No HCV treatment failure has been noted. There were no differences in 30-day and 1-year graft and patient survival, length of hospital stay, biliary or vascular complications, or cytomegalovirus viremia between the 2 groups. In this interim analysis of a matched cohort study, which is the first and largest study to date, the patients who received the HCV NAT+ organs had similar outcomes regarding graft function, patient survival, and post-LT complications.
(Copyright © 2020 by the American Association for the Study of Liver Diseases.)
Databáze: MEDLINE
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