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The Use of Grafts from HCV+ Patients in Transplantation: Are we There Yet?

  • Hepatitis C (H Vargas and S Flamm, Section Editors)
  • Published:
Current Hepatology Reports Aims and scope Submit manuscript

Abstract

Use of organs from donors previously or currently infected with hepatitis C virus is gaining interest in the transplantation realm.

Purpose of Review

Here we will outline the historical perspectives for discarding such organs, review the reasons for revitalized interest in their use, and highlight available data on the use of hepatitis C virus (HCV)-viremic grafts in transplantation. We will summarize arguments supporting and against such practices and offer our recommendations.

Recent Findings

HCV can now be safely and effectively treated post transplantation with direct-acting antivirals (DAAs). Several reports are highlighted in which HCV-viremic organ donation was performed, followed by DAA treatment. However, opinions abound on the appropriateness of this practice.

Summary

Use of viremic organs requires further study and additional larger-scale data with longer-term follow-up, but overall appears safe. It is a viable method to expand the donor pool in both liver and non-liver organ transplantation, but must be carefully weighed with the risks.

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Abbreviations

HCV:

Hepatitis C virus

AASLD:

American Association for the Study of Liver Disease

IDSA:

Infectious Diseases Society of America

PCR:

Polymerase chain reaction

NAT:

Nucleic acid testing

SVR12:

Sustained virological response at 12 weeks

DAA:

Direct-acting antiviral

CMV:

Cytomegalovirus

EBV:

Epstein-Barr virus

IRD:

Increased-risk donor

AST:

American Society of Transplantation

HCC:

Hepatocellular carcinoma

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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  1. Division of Gastroenterology and Hepatology and Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, 60601, USA

    Kathy M. Nilles & Steven L. Flamm

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Nilles, K.M., Flamm, S.L. The Use of Grafts from HCV+ Patients in Transplantation: Are we There Yet?. Curr Hepatology Rep 18, 233–241 (2019). https://doi.org/10.1007/s11901-019-00466-0

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