Use of HCV Ab+/NAT- donors in HCV naïve renal transplant recipients to expand the kidney donor pool
| Autor: | Shimul A. Shah, Tayyab S. Diwan, Ann Dao, A. H. Rike, John Cafardi, Amit Govil, Madison C. Cuffy, E. S. Woodle, Kenneth E. Sherman, Keith Luckett, Rita R. Alloway, Ashley Loethen, Michael Cardi, Tiffany E. Kaiser |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Tissue and Organ Procurement medicine.medical_treatment Hepacivirus Gastroenterology Donor Selection Risk Factors Internal medicine medicine Humans Donor pool Transplantation Kidney business.industry fungi Graft Survival virus diseases Immunosuppression Hepatitis C Glecaprevir Hepatitis C Antibodies Middle Aged Viral Load medicine.disease Prognosis Kidney Transplantation digestive system diseases Pibrentasvir Tissue Donors Transplant Recipients medicine.anatomical_structure Uronic Acids Renal transplant Nat Kidney Failure Chronic Female business Follow-Up Studies |
| Zdroj: | Clinical transplantation. 33(7) |
| ISSN: | 1399-0012 |
| Popis: | Hepatitis C (HCV) disease transmission from the use of HCV antibody-positive and HCV nucleic acid test-negative (HCV Ab+/NAT-) kidneys have been anecdotally reported to be absent. We prospectively analyzed kidney transplant (KT) outcomes from HCV Ab+/NAT- donors to HCV naive recipients under T-cell depleting early steroid withdrawal immunosuppression. Allografts from 40 HCV Ab+/NAT- donors were transplanted to 52 HCV Ab- recipients between July 2016 and February 2018. Thirty-three (82.5%) of donors met Public Health Service (PHS) increased risk criteria. De novo HCV infection was detected at 3 months post-KT in one recipient (1.9%). This was a case of transmission from a HCV Ab+ NAT+ donor with an initial false-negative NAT completed using sample collected on donor hospital admission (day 2). At the time of HCV diagnosis, a stored donor sample collected during procurement (day 4) was tested and resulted NAT-positive. Subsequently, sustained virologic response (SVR) was achieved with 12 weeks of glecaprevir/pibrentasvir. One death with functioning graft at 261 days post-KT was determined not related to HCV or donor factors. This experience provides evidence of a low transmission rate of HCV from HCV Ab+/ NAT- kidney donors, thereby arguing for increasing utilization. |
| Databáze: | OpenAIRE |
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