Renal transplantation from seropositive hepatitis C virus donors to seronegative recipients in Spain: a prospective study. (10th March 2019)

• Record Type: Journal Article
• Authors: Franco, Antonio; Moreso, Francesc; Merino, Esperanza; Sancho, Asunción; Kanter, Julia; Gimeno, Adelina; Balibrea, Noelia; Rodriguez, Maria; Perez Contreras, Francisco
• Is Part Of: Transplant international. Volume 32:Number 7(2019)
• Page Start: 710
• Page End: 716
• Publication Date: 2019-03-10
• Subjects: direct acting antiviral agents -- hepatitis C virus -- nuclear acid testing -- renal transplantation -- seronegative recipient -- viremia; Transplantation of organs, tissues, etc -- Periodicals; 617.95405
• DOI: 10.1111/tri.13410
• Languages: English
• ISSNs: 0934-0874

Abstract

Summary: Hepatitis C virus (HCV) positive donors are identified in Spain by antibody detection (HCV‐Ab) techniques while a HCV nuclear acid‐testing (HCV‐NAT) is not mandatory. Since it has been shown that HCV‐Ab positive HCV‐NAT negative donors do not universally transmit the infection, we designed a protocol based on the identification of viremia in HCV‐Ab positive donors to start treatment if needed. HCV‐Ab‐positive donors were identified and we performed HCV‐NAT immediately. Donors coinfected with HIV were excluded. Recipients with a low chance to receive a transplant, with no history of liver disease and who were negative for HCV‐Ab were selected after informed consent was signed. Kidney recipients from HCV‐NAT‐positive donors received glecaprevir and pibrentasvir from 6 h before the transplant until 8 weeks after. Recipients from HCV‐NAT‐negative donors were not treated. Regular monitoring by HCV‐NAT was performed to initiate antiviral treatment. We included 11 recipients from six deceased donors Four recipients received grafts from HCV‐NAT‐positive donors and seven patients received grafts from HCV‐NAT‐negative donors. None of our recipients exhibited HCV‐NAT positivity during the minimum follow‐up period of 6 months. Recipients from HCV‐NAT‐positive donors exhibited sustained virologic response at 12 weeks. One recipient from an HCV‐NAT‐negative donor lost his graft via a process thought to be unrelated to HCV. The remaining 10 patients had a stable functioning graft at the end of the follow‐up period. Our preliminary data suggest that renal transplantation from HCV‐Ab‐ positive donors to HCV‐Ab negative recipients is safe when only the recipients of organs from HCV‐NAT‐positive donors are treated.