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Review
. 2022 May 3:35:10277.
doi: 10.3389/ti.2022.10277. eCollection 2022.

Kidney Transplantation From Hepatitis-C Viraemic Donors:Considerations for Practice in the United Kingdom

Daniel T Doherty  1   2 , Varinder Athwal  2   3 , Zia Moinuddin  1   2 , Titus Augustine  1   2 , Martin Prince  2   3 , David van Dellen  1   2 , Hussein A Khambalia  1   2
Affiliations
Review

Kidney Transplantation From Hepatitis-C Viraemic Donors:Considerations for Practice in the United Kingdom

Daniel T Doherty et al. Transpl Int. .

Abstract

Background: Donor hepatitis-C (HCV) infection has historically represented a barrier to kidney transplantation (KT). However, direct-acting antiviral (DAA) medications have revolutionised treatment of chronic HCV infection. Recent American studies have demonstrated that DAA regimes can be used safely peri-operatively in KT to mitigate HCV transmission risk. Methods: To formulate this narrative review, a comprehensive literature search was performed to analyse results of existing clinical trials examining KT from HCV-positive donors to HCV-negative recipients with peri-operative DAA regimes. Results: 13 studies were reviewed (11 single centre, four retrospective). Outcomes for 315 recipients were available across these studies. A sustained virological response at 12 weeks (SVR12) of 100% was achieved in 11 studies. One study employed an ultra-short DAA regime and achieved an SVR12 of 98%, while another achieved SVR12 of 96% due to treatment of a missed mixed genotype. Conclusion: HCV+ KT is safe and may allow increased utilisation of organs for transplantation from HCV+ donors, who often have other favourable characteristics for successful donation. Findings from US clinical trials can be applied to the United Kingdom transplant framework to improve organ utilisation as suggested by the NHSBT vision strategy "Organ Donation and Transplantation 2030: meeting the need".

Keywords: donor; hepatitis C infection; kidney transplant; utilisation; viraemia.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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