Hepatitis C Virus NAT-Positive Solid Organ Allografts Transplanted Into Hepatitis C Virus-Negative Recipients: A Real-World Experience
| Autor: | Joshua J. Shaw, Xaralambos Zervos, Salwa Rhazouani, Cristiano Quintini, Nikhil Kapila, Kawtar Al-Khalloufi, Neerja Agrawal, Viviana Navas, Carla Murgas, Diego Reino, K. V. Narayanan Menon, Christina C. Lindenmeyer, Michael Castillo, Asad Ur Rahman, Jason M. Vanatta, Samer Ebaid, Cedric Sheffield, Charles Miller |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty Sustained Virologic Response Hepatitis C virus Hepacivirus medicine.disease_cause Antiviral Agents 03 medical and health sciences 0302 clinical medicine Primary outcome Postoperative Complications Internal medicine Antibody negative medicine Humans Viremia Aged Aged 80 and over Hepatology medicine.diagnostic_test business.industry virus diseases Nucleic acid test Middle Aged Allografts Hepatitis C Kidney Transplantation digestive system diseases Tissue Donors Liver Transplantation Transplantation 030104 developmental biology DNA Viral Heart Transplantation 030211 gastroenterology & hepatology Female Solid organ business Solid organ transplantation Viral load Nucleic Acid Amplification Techniques |
| Zdroj: | Hepatology (Baltimore, Md.)References. 72(1) |
| ISSN: | 1527-3350 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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