Best practice recommendations for the use of hepatitis C viremic donor organs for hepatitis C virus naïve recipients

Zoe A. Stewart, Shimul A. Shah, Jason A. Rolls, James V. Guarrera, Raja Kandaswamy, David A. Axelrod

Research output: Contribution to journalArticlepeer-review

Abstract

The combination of the transplant organ deficit, the increase in HCV nucleic acid positive donors (HCV NAT+), and the development of direct-acting antiviral agents (DAAs) has resulted in a rapid increase in HCV NAT+ organ transplants into HCV naïve recipients. Early clinical experience with HCV NAT+ donor organs has shown promising outcomes; however, best practices are lacking to guide transplant programs during all phases of patient care. Transplant programs developing protocols for the utilization of HCV NAT+ organs will need a multidisciplinary team to address all aspects of pre-transplant and post-transplant patient care. Reports of fibrosing cholestatic hepatitis in HCV NAT+ organ transplant recipients receiving delayed DAA initiation highlight the need for the transplant community to develop safe and effective protocols. A failure to do so will inevitably lead to the erosion of public trust from cases of missed or inadequately treated donor-derived HCV infections. Herein, we provide best practice guidelines for the utilization of HCV NAT+ organs into HCV-negative recipients based on literature review and expert opinion from the faculty of the ASTS Standards and Quality Committee.

Original languageEnglish (US)
JournalClinical Transplantation
Early online dateJun 4 2021
DOIs
StatePublished - Jun 16 2021

Bibliographical note

Publisher Copyright:
© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Keywords

  • abdominal transplantation
  • hepatitis C donor
  • thoracic transplantation

PubMed: MeSH publication types

  • Journal Article

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