Journal
TRANSPLANT INFECTIOUS DISEASE
Volume 21, Issue 6, Pages -Publisher
WILEY
DOI: 10.1111/tid.13194
Keywords
direct-acting antiviral; hepatitis C virus-negative recipient; hepatitis C virus-positive donor liver; liver transplantation; preemptive antiviral therapy
Categories
Funding
- National Institute of Diabetes and Digestive and Kidney Diseases [K23DK115908]
- National Cancer Institute [K23CA177321]
- Johns Hopkins Institute for Clinical and Translational Research (ICTR) [KL2TR001077]
- National Center for Advancing Translational Sciences
- National Institute on Drug Abuse [K24DA034621]
- Johns Hopkins Osler Medical Housestaff Training Program Osler Fund
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Background The opioid crisis has led to an increase in hepatitis C virus-positive donors in the past decade. Whereas historically hepatitis C seropositive organs were routinely discarded, the advent of direct-acting antiviral agents has notably expanded the utilization of organs from donors with hepatitis C. There has been growing experience with liver transplantation (LT) from hepatitis C seropositive donors to hepatitis C seropositive recipients. However, data remain limited on LT from hepatitis C seropositive or hepatitis C ribonucleic acid positive donors to hepatitis C seronegative recipients. Methods We performed a retrospective study of 26 hepatitis C seronegative recipients who received hepatitis C seropositive donor livers followed by preemptive antiviral therapy with direct-acting antiviral treatment at the Johns Hopkins Hospital Comprehensive Transplant Center from January 1, 2017, to August 31, 2019. Results Twenty-five of the 26 recipients are alive with proper graft function; 20 of them received livers from hepatitis C nucleic acid testing positive donors. All 12 recipients who completed their direct-acting antiviral courses and have reached sufficient follow-up for sustained virologic response have achieved sustained virologic response. Nine of our recipients have either completed direct-acting antiviral treatment without sufficient follow-up time for sustained virologic response or are undergoing direct-acting antiviral treatment. One patient is awaiting antiviral treatment initiation pending insurance approval. Of note, 11 of 12 patients with sustained virologic response received a hepatitis C nucleic acid testing positive donor liver. Conclusion Hepatitis C seronegative patients who receive a hepatitis C seropositive or hepatitis C nucleic acid testing positive liver allograft can enjoy good short-term outcomes with hepatitis C cure following direct-acting antiviral treatment.
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