Transplantation of viral‐positive hepatitis C‐positive kidneys into uninfected recipients offers an opportunity to increase organ access
Autor: | Jay A. Graham, Luz E. Liriano, Stuart M. Greenstein, Milan Kinkhabwala, Cindy Pynadath, John F. Reinus, Y. Goldstein, Yorg Azzi, Juan P. Rocca, Jeffery M. Weiss, Maria Ajaimy, Enver Akalin, Julia Torabi, Tia Powell, Amy S. Fox |
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Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Viremia Hepacivirus 030230 surgery Kidney Antiviral Agents Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Adverse effect Transplantation business.industry Hepatitis C Hepatitis C Chronic medicine.disease Kidney Transplantation Delayed Graft Function Cohort 030211 gastroenterology & hepatology business Viral load Kidney disease |
Zdroj: | Clinical Transplantation. 34 |
ISSN: | 1399-0012 0902-0063 |
Popis: | The advent of direct-acting antivirals (DAAs) has provided the impetus to transplant kidneys from hepatitis C virus-positive donors into uninfected recipients (D+/R-). Thirty D+/R- patients received DAA treatment. Sustained virologic response (SVR12) was defined as an undetectable viral load in 12 weeks after treatment. An age-matched cohort of uninfected donor and recipient pairs (D-/R-) transplanted during same time period was used for comparison. The median day of viral detection was postoperative day (POD) 2. The detection of viremia in D+/R- patients was 100%. The initial median viral load was 531 copies/μL (range: 10-1 × 108 copies/μL) with a median peak viral load of 3.4 × 105 copies/μL (range: 804-1.0 × 108 copies/μL). DAAs were initiated on median POD 9 (range: 5-41 days). All 30 patients had confirmed SVR12. During a median follow-up of 10 months, patient and graft survival was 100%, and acute rejection was 6.6% with no major adverse events related to DAA treatment. Delayed graft function was significantly decreased in D+/R- patients as compared to the age-matched cohort (27% vs 60%; P = .01). D+/R- transplantation offers patients an alternative strategy to increase access. |
Databáze: | OpenAIRE |
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