Hepatitis C Virus NAT-Positive Solid Organ Allografts Transplanted Into Hepatitis C Virus-Negative Recipients : A Real-World Experience
© 2019 by the American Association for the Study of Liver Diseases..
BACKGROUND AND AIMS: Hepatitis C virus (HCV)-viremic organs are underutilized, and there is limited real-world experience on the transplantation of HCV-viremic solid organs into recipients who are HCV negative.
APPROACH AND RESULTS: Patients listed or being evaluated for solid organ transplant after January 26, 2018, were educated and consented by protocol on the transplantation of HCV-viremic organs. All recipients were HCV nucleic acid test and anti-HCV antibody negative at the time of transplant and received an HCV-viremic organ. The primary outcome was sustained virological response (SVR) at 12 weeks after completion of direct-acting antiviral (DAA) therapy (SVR12 ). Seventy-seven patients who were HCV negative underwent solid organ transplantation from a donor who was HCV viremic. No patients had evidence of advanced hepatic fibrosis. Treatment regimen and duration were at the discretion of the hepatologist. Sixty-four patients underwent kidney transplant (KT), and 58 KT recipients had either started or completed DAA therapy. Forty-one achieved SVR12 , 10 had undetectable viral loads but are not eligible for SVR12 , and 7 remain on treatment. One KT recipient was a nonresponder because of nonstructural protein 5A resistance. Four patients underwent liver transplant and 2 underwent liver-kidney transplant. Three patients achieved SVR12 , 1 has completed DAA therapy, and 2 remain on treatment. Six patients underwent heart transplant and 1 underwent heart-kidney transplant. Six patients achieved SVR12 and 1 patient remains on treatment.
CONCLUSIONS: Limited data exist on the transplantation of HCV-viremic organs into recipients who are HCV negative. Our study is the largest to describe a real-world experience of the transplantation of HCV-viremic organs into recipients who are aviremic. In carefully selected patients, the use of HCV-viremic grafts in the DAA era appears to be efficacious and well tolerated.
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:72 |
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| Enthalten in: |
Hepatology (Baltimore, Md.) - 72(2020), 1 vom: 01. Juli, Seite 32-41 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kapila, Nikhil [VerfasserIn] |
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Date Completed 06.05.2021 Date Revised 06.05.2021 published: Print-Electronic CommentIn: Hepatology. 2020 Aug;72(2):787. - PMID 32060932 Citation Status MEDLINE |
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| doi: |
10.1002/hep.31011 |
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| funding: |
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| PPN (Katalog-ID): |
NLM302644776 |
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| 245 | 1 | 0 | |a Hepatitis C Virus NAT-Positive Solid Organ Allografts Transplanted Into Hepatitis C Virus-Negative Recipients |b A Real-World Experience |
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| 500 | |a Date Completed 06.05.2021 | ||
| 500 | |a Date Revised 06.05.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Hepatology. 2020 Aug;72(2):787. - PMID 32060932 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2019 by the American Association for the Study of Liver Diseases. | ||
| 520 | |a BACKGROUND AND AIMS: Hepatitis C virus (HCV)-viremic organs are underutilized, and there is limited real-world experience on the transplantation of HCV-viremic solid organs into recipients who are HCV negative | ||
| 520 | |a APPROACH AND RESULTS: Patients listed or being evaluated for solid organ transplant after January 26, 2018, were educated and consented by protocol on the transplantation of HCV-viremic organs. All recipients were HCV nucleic acid test and anti-HCV antibody negative at the time of transplant and received an HCV-viremic organ. The primary outcome was sustained virological response (SVR) at 12 weeks after completion of direct-acting antiviral (DAA) therapy (SVR12 ). Seventy-seven patients who were HCV negative underwent solid organ transplantation from a donor who was HCV viremic. No patients had evidence of advanced hepatic fibrosis. Treatment regimen and duration were at the discretion of the hepatologist. Sixty-four patients underwent kidney transplant (KT), and 58 KT recipients had either started or completed DAA therapy. Forty-one achieved SVR12 , 10 had undetectable viral loads but are not eligible for SVR12 , and 7 remain on treatment. One KT recipient was a nonresponder because of nonstructural protein 5A resistance. Four patients underwent liver transplant and 2 underwent liver-kidney transplant. Three patients achieved SVR12 , 1 has completed DAA therapy, and 2 remain on treatment. Six patients underwent heart transplant and 1 underwent heart-kidney transplant. Six patients achieved SVR12 and 1 patient remains on treatment | ||
| 520 | |a CONCLUSIONS: Limited data exist on the transplantation of HCV-viremic organs into recipients who are HCV negative. Our study is the largest to describe a real-world experience of the transplantation of HCV-viremic organs into recipients who are aviremic. In carefully selected patients, the use of HCV-viremic grafts in the DAA era appears to be efficacious and well tolerated | ||
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| 700 | 1 | |a Al-Khalloufi, Kawtar |e verfasserin |4 aut | |
| 700 | 1 | |a Vanatta, Jason M |e verfasserin |4 aut | |
| 700 | 1 | |a Murgas, Carla |e verfasserin |4 aut | |
| 700 | 1 | |a Reino, Diego |e verfasserin |4 aut | |
| 700 | 1 | |a Ebaid, Samer |e verfasserin |4 aut | |
| 700 | 1 | |a Shaw, Joshua J |e verfasserin |4 aut | |
| 700 | 1 | |a Agrawal, Neerja |e verfasserin |4 aut | |
| 700 | 1 | |a Rhazouani, Salwa |e verfasserin |4 aut | |
| 700 | 1 | |a Navas, Viviana |e verfasserin |4 aut | |
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