Transplantation of kidneys from hepatitis C-positive donors into hepatitis C virus-infected recipients followed by early initiation of direct acting antiviral therapy: a single-center retrospective study
- Resource Type
- Authors
- Adela Mattiazzi; Gaetano Ciancio; Marco Ladino; Fernando Pedraza; David M. Roth; Paul J. Martin; Linda Chen; Kalyan Ram Bhamidimarri; Giselle Guerra; George W. Burke; Warren Kupin
- Source
- Transplant International. 30:865-873
- Subject
- Adult
Male
medicine.medical_specialty
Pyrrolidines
Hepatitis C virus
030232 urology & nephrology
030230 surgery
medicine.disease_cause
Single Center
Antiviral Agents
Donor Selection
03 medical and health sciences
0302 clinical medicine
Simeprevir
Internal medicine
Ribavirin
medicine
Humans
Aged
Retrospective Studies
Postoperative Care
Fluorenes
Transplantation
Kidney
business.industry
Imidazoles
Valine
Retrospective cohort study
Hepatitis C
Hepatitis C, Chronic
Middle Aged
medicine.disease
Kidney Transplantation
Tissue Donors
Treatment Outcome
medicine.anatomical_structure
Immunology
Cohort
Kidney Failure, Chronic
Benzimidazoles
Drug Therapy, Combination
Female
Carbamates
Sofosbuvir
business
Direct acting
Follow-Up Studies
- Language
- ISSN
- 0934-0874
The availability of direct acting antiviral agents (DAA) has transformed the treatment of hepatitis C virus (HCV) infection. The current study is a case series that reports the outcomes from a cohort of twenty-five HCV-infected ESRD patients who received a kidney from an anti-HCV-positive deceased organ donor followed by treatment with DAAs in the early post-transplant period. Time to transplantation and the efficacy of DAA therapy as measured by sustained viral response at 12 weeks were assessed. The median waiting time from original date of activation on the United Network Organ Sharing (UNOS) waiting list until transplantation was 427 days; however, the median time from entering the patient into UNetsm for a HCV-positive offer until transplantation was only 58 days. The 25 patients were started on antiviral treatment early post-transplant (median 125 days) and 24 of 25 (96%) achieved a sustained virologic response at 12 weeks. Tacrolimus dose adjustments were required during antiviral treatment in 13 patients to maintain therapeutic levels. Accepting a kidney from an anti-HCV-positive deceased donor shortened the waiting time for HCV-infected kidney transplant candidates. We recommend that kidneys from anti-HCV-positive donors should be considered for transplant into HCV-infected recipients followed by early post-transplant treatment with DAA agents.