Utilizing Donors with Hepatitis C Antibody Positivity and Negative Nucleic Acid Testing
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The demand for organs in the USA exceeds supply resulting in high mortality for patients awaiting transplantation. To increase the pool of available organs, the transplant community is investigating the safety and utility of organs previously considered high risk. Guidelines currently advocate for the use of hepatitis C antibody, nucleic acid testing (NAT)-negative organs in hepatitis C–positive recipients. However, data is limited regarding outcomes of using such grafts in hepatitis C–negative recipients.
Purpose of Review
The purpose of this paper is to review the literature on utilizing hepatitis C virus (HCV)-positive NAT-negative livers and to determine if utilizing direct-acting antivirals lowers the risk of HCV transmission regardless of the recipient’s HCV status.
The current literature demonstrates that the overall risk of transmission of HCV with the use of these organs in HCV-negative recipients is low and that risk is increased with high-risk donors that died from IVDA overdose.
Direct-acting antivirals are highly effective in treating HCV and lowering the risk of transmission. Therefore, we should reconsider utilizing these organs in HCV-positive recipients.
KeywordsLiver transplantation Extended criteria donors Nucleic acid test HCV antibody-positive/NAT-negative donors HCV transplant transmission risk Hepatitis C–positive donors Occult hepatitis C
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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