Utilization of Hepatitis C Virus-Infected Donor Hearts in Two Children and Two Young Adults: Initial Experience at a Pediatric Transplant Center.

Autor: Kushner LE; Division of Pediatric Infectious Diseases, Department of Pediatrics, Stanford University School of Medicine, California, USA., Puckett L; Department of Pharmacy, Lucile Packard Children's Hospital at Stanford, California, USA., Lee J; Department of Pharmacy, Lucile Packard Children's Hospital at Stanford, California, USA., Gans HA; Division of Pediatric Infectious Diseases, Department of Pediatrics, Stanford University School of Medicine, California, USA., Nadimpalli S; Division of Pediatric Infectious Diseases, Department of Pediatrics, Stanford University School of Medicine, California, USA., Chen S; Division of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, California, USA., Ma M; Division of Pediatric Cardiac Surgery, Department of Cardiothoracic Surgery, Stanford University School of Medicine, California, USA., Chen SF; Division of Pediatric Infectious Diseases, Department of Pediatrics, Stanford University School of Medicine, California, USA., Profita EL; Division of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, California, USA.
Jazyk: angličtina
Zdroj: Pediatric transplantation [Pediatr Transplant] 2024 Nov; Vol. 28 (7), pp. e14879.
DOI: 10.1111/petr.14879
Abstrakt: Background: Although adult transplant centers are successfully transplanting organs from hepatitis C virus (HCV)-infected donors with detectable viral load by nucleic acid testing (NAT+) into HCV-negative recipients, this practice has not yet been adopted widely by the pediatric heart transplant community.
Methods: We present a case series of four patients who received heart transplants from HCV NAT+ donors at a pediatric transplant center, including two pediatric patients < 18 years of age.
Results: All recipients tolerated a 12-week course of glecaprevir/pibrentasvir and achieved a sustained virologic response with no HCV or liver complications with over 1 year of follow-up (range 1.4-2.5 years). All four have had good post-heart transplant outcomes with normal graft function and good functional status without rejection or cardiac allograft vasculopathy at time of last follow-up.
Conclusions: This case series details the successful multidisciplinary implementation of a protocol to accept cardiac allografts from HCV NAT+ donors for transplantation into HCV negative recipients at our pediatric transplant center. With the limited donor pool in pediatrics and the morbidity associated with prolonged durations on the transplant waitlist, pediatric centers should consider utilizing organs from HCV NAT+ donors to broaden the donor pool. Future work should evaluate other organs beyond heart and optimal timing and duration of direct acting antiviral therapy.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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