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Utilization of hepatitis C viremic donors for liver transplant recipients without hepatitis C. A veterans transplant center report
Author(s) -
Said Adnan,
Weiss Matthew,
Varhelyi Anna,
Farago Rebecca,
Ballweg Cristy,
Rice John,
Agarwal Parul,
Fernandez Luis,
Foley David
Publication year - 2021
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.13466
Subject(s) - medicine , viremia , hepatitis c , hepatitis c virus , liver transplantation , viral load , gastroenterology , transplantation , immunology , virus
Background We report our experience utilizing liver donors with HCV Viremia (RNA+) for HCV‐negative recipients (HCV D+R−) at a Veterans Affairs (VA) transplant center. Methods In 2018, we introduced an informed consent process for HCV D+R− liver transplants. Results Eight HCV D+R− liver transplants (LT) were performed. Median time from listing to LT was 189 days (range 41‐511). Median MELD at LT was 23.5 (median MELD at LT of 31 for center). All recipients developed HCV viremia after transplant. Median time to DAA initiation was 10 days after viremia (range 3‐25). After transplant, the DAAs used were Mavyret in five recipients and Epclusa in three, all for 12 weeks. All eight patients completed DAA therapy and achieved negative HCV RNA by end of therapy (ETR) and seven reached sustained virologic response (SVR) by 12 weeks after end of therapy. One patient died from chronic ischemic encephalopathy after ETR, before SVR. Conclusions HCV D+R− is a practical strategy to expand the pool of donor organs. It shortened waiting time, allowing patients to receive transplants at lower MELD scores. VA liver transplant programs have provided universal and timely access to post‐transplant HCV DAA therapy after donor‐derived infection.