Transplantation of viral-positive hepatitis C-positive kidneys into uninfected recipients offers an opportunity to increase organ access

Research output: Contribution to journalArticle

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Abstract

The advent of direct-acting antivirals (DAAs) has provided the impetus to transplant kidneys from hepatitis C virus-positive donors into uninfected recipients (D+/R−). Thirty D+/R− patients received DAA treatment. Sustained virologic response (SVR12) was defined as an undetectable viral load in 12 weeks after treatment. An age-matched cohort of uninfected donor and recipient pairs (D−/R−) transplanted during same time period was used for comparison. The median day of viral detection was postoperative day (POD) 2. The detection of viremia in D+/R− patients was 100%. The initial median viral load was 531 copies/μL (range: 10-1 × 108 copies/μL) with a median peak viral load of 3.4 × 105 copies/μL (range: 804-1.0 × 108 copies/μL). DAAs were initiated on median POD 9 (range: 5-41 days). All 30 patients had confirmed SVR12. During a median follow-up of 10 months, patient and graft survival was 100%, and acute rejection was 6.6% with no major adverse events related to DAA treatment. Delayed graft function was significantly decreased in D+/R− patients as compared to the age-matched cohort (27% vs 60%; P =.01). D+/R− transplantation offers patients an alternative strategy to increase access.

Original languageEnglish (US)
Article numbere13833
JournalClinical Transplantation
Volume34
Issue number4
DOIs
StatePublished - Apr 1 2020

Keywords

  • donor-derived infections
  • donors and donation
  • hepatitis C
  • infection and infectious agents
  • kidney disease
  • viral

ASJC Scopus subject areas

  • Transplantation

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