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Hepatitis C‐positive donor liver transplantation for hepatitis C seronegative recipients
Author(s) -
Ting Pengsheng,
Hamilton James Peter,
Gurakar Ahmet,
Urrunaga Nathalie H.,
Ma Michelle,
Glorioso Jaime,
King Elizabeth,
Toman Lindsey P.,
Wesson Russell,
GaronzikWang Jacqueline,
Ottmann Shane,
Philosophe Benjamin,
Sulkowski Mark,
Cameron Andrew M.,
Durand Christine M.,
Chen PoHung
Publication year - 2019
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.13194
Subject(s) - medicine , hepatitis c , hepatitis , hepatitis c virus , liver transplantation , hepatitis b , viral hepatitis , immunology , hepatitis a , transplantation , gastroenterology , virology , virus
Background The opioid crisis has led to an increase in hepatitis C virus‐positive donors in the past decade. Whereas historically hepatitis C seropositive organs were routinely discarded, the advent of direct‐acting antiviral agents has notably expanded the utilization of organs from donors with hepatitis C. There has been growing experience with liver transplantation (LT) from hepatitis C seropositive donors to hepatitis C seropositive recipients. However, data remain limited on LT from hepatitis C seropositive or hepatitis C ribonucleic acid positive donors to hepatitis C seronegative recipients. Methods We performed a retrospective study of 26 hepatitis C seronegative recipients who received hepatitis C seropositive donor livers followed by preemptive antiviral therapy with direct‐acting antiviral treatment at the Johns Hopkins Hospital Comprehensive Transplant Center from January 1, 2017, to August 31, 2019. Results Twenty‐five of the 26 recipients are alive with proper graft function; 20 of them received livers from hepatitis C nucleic acid testing positive donors. All 12 recipients who completed their direct‐acting antiviral courses and have reached sufficient follow‐up for sustained virologic response have achieved sustained virologic response. Nine of our recipients have either completed direct‐acting antiviral treatment without sufficient follow‐up time for sustained virologic response or are undergoing direct‐acting antiviral treatment. One patient is awaiting antiviral treatment initiation pending insurance approval. Of note, 11 of 12 patients with sustained virologic response received a hepatitis C nucleic acid testing positive donor liver. Conclusion Hepatitis C seronegative patients who receive a hepatitis C seropositive or hepatitis C nucleic acid testing positive liver allograft can enjoy good short‐term outcomes with hepatitis C cure following direct‐acting antiviral treatment.