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. 2021 Apr;23(2):e13466.
doi: 10.1111/tid.13466. Epub 2020 Sep 25.

Utilization of hepatitis C viremic donors for liver transplant recipients without hepatitis C. A veterans transplant center report

Adnan Said  1 , Matthew Weiss  1 , Anna Varhelyi  1 , Rebecca Farago  1 , Cristy Ballweg  1 , John Rice  1 , Parul Agarwal  1 , Luis Fernandez  1 , David Foley  1
Affiliations

Utilization of hepatitis C viremic donors for liver transplant recipients without hepatitis C. A veterans transplant center report

Adnan Said et al. Transpl Infect Dis. 2021 Apr.

Abstract

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.

Keywords: HCV viremic donor; HCV-negative recipient; direct-acting antiviral therapy; expanded donor pool; hepatitis C; liver transplantation.

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References

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