Liver, simultaneous liver‐kidney, and kidney transplantation from hepatitis C‐positive donors in hepatitis C‐negative recipients: A single‐center study

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.