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Liver, simultaneous liver‐kidney, and kidney transplantation from hepatitis C‐positive donors in hepatitis C‐negative recipients: A single‐center study
Author(s) -
Crismale James F.,
Khalid Mian,
Bhansali Arjun,
Boccardo Graciela,
Khaim Rafael,
Florman Sander S.,
Shapiro Ron,
Schiano Thomas D.
Publication year - 2020
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13761
Subject(s) - medicine , immunosuppression , hepatitis c , nucleic acid test , interquartile range , hepatitis c virus , nat , transplantation , gastroenterology , liver transplantation , kidney , viremia , kidney transplantation , immunology , antibody , virus , covid-19 , computer network , disease , computer science , infectious disease (medical specialty)
Abstract Transplantation of organs from hepatitis C virus (HCV)‐antibody (Ab) and ‐nucleic acid test (NAT) positive donors into HCV‐negative recipients has been proposed to expand the donor pool and shorten waiting times. Data on early single‐center outcomes are lacking. Nineteen liver (LT, including seven simultaneous liver‐kidney [SLKT]) and 17 kidney transplant (KT) recipients received organs from HCV (+) donors; of these, 13 were HCV NAT (+) in each group. All patients who received organs from HCV NAT (+) donors developed HCV viremia post‐transplant except for 2 KT recipients. Patients were treated with a variety of direct‐acting antiviral regimens, with high rates of sustained virologic response among those with at least 12 weeks of follow‐up past the end of treatment: 12/13 (92%) and 8/8 (100%) among LT/SLKT, and KT recipients. Median time to treatment start was 42 days (interquartile range [IQR] 35‐118 days) and 40 days (IQR 26‐73) post‐LT/SLKT and KT, respectively. One death occurred in a SLKT recipient unrelated to HCV or its treatment. There was no significant increase in rejection, proteinuria, or changes in immunosuppression in any group. Organs from HCV‐viremic donors can be utilized for HCV‐uninfected recipients with good short‐term outcomes.