Protocol for the Management of Hepatitis C Transferred Through Kidney Transplantation

Document Type

Conference Proceeding

Publication Date

10-1-2024

Publication Title

Am J Gastroenterol

Abstract

Introduction: The effectiveness of direct-acting antiviral (DAA) drugs for treating hepatitis C virus (HCV) infection may substantially increase the number of available organs for transplants by allowing organ transplantation from HCV-positive (HCV1) donors into HCV-negative (HCV-) recipients. This study describes the outcomes of HCV- recipients who received kidneys from HCV1 donors, highlighting the benefits of post-transplant DAA therapy. Methods: This was a single center retrospective case series of all HCV- recipients who underwent kidney transplantation with organs from HCV1 donors at our transplant center from October 2020 to May 2023. Results: There were 11 HCV- recipients who underwent deceased donor kidney transplantation (DDKT) with organs from HCV+ donors: 9 men (82%) and 2 women (18%). There was 1 patient who received both liver and kidney. The median age was 60 years (range 41-76). The mean organ wait time spent on dialysis was 1.9 years. All patients were confirmed HCV- by quantitative nucleic acid amplification test at the time of transplant, and 9 (82%) patients tested HCV+ after transplantation. Of these 9 HCV infections, 6 were genotype 1a, 1 was 1b, and 2 were 2b. Notably, 8 of these 9 patients received DAA therapy for 12 weeks (6 sofosbuvir/velpatasvir and 2 glecaprevir/pibrentasvir), and all 8 patients had undetectable virus at 8 weeks of treatment with no side effects requiring early treatment termination. Also, none developed graft rejection or glomerulonephritis from HCV infection, although 2 patients had delayed graft function that improved. Within 1 year of transplant, 2 of the 8 patients died due to comorbidities unrelated to HCV or transplant. The 1-year survival for all kidney transplant recipients at our center between 2021 and 2022 was 96%. Conclusion: All HCV- patients who received an HCV+ DDKT and were treated with DAA therapy for post-transplant HCV infection had complete resolution of HCV. Patients receiving an HCV+ DDKT underwent transplant much earlier than expected, at around 1.9 years of dialysis waiting (DDKT wait time for type O patients is 5 years in Michigan). Effective DAA therapy now allows kidneys from HCV1 donors to be a safe source of organs for transplantation.

Volume

119

Issue

10

First Page

S1320

Find It @ Sladen

Share

COinS