In:
Current Opinion in Organ Transplantation, Ovid Technologies (Wolters Kluwer Health), Vol. 28, No. 1 ( 2023-02), p. 22-28
Abstract:
Direct-acting antivirals (DAA) have transformed kidney transplantation by increasing the donor pool from hepatitis C virus (HCV)-infected donors and allowing HCV nucleic acid amplification testing (NAT) donor-positive/recipient-negative (D+/R-) transplantation over the last 7 years. Willingness to accept kidneys from HCV-infected donors and timing/duration of DAA therapy have been evolving. Recent findings By 2021, most of the HCV NAT+ kidneys (92.6%) were transplanted to HCV-naive recipients. Despite the availability of effective DAA therapy, the discard rate of HCV NAT kidneys has been stagnant around 25%. The proportion of wait-listed patients willing to accept a deceased donor kidney from HCV Ab+ and HCV NAT+ donors increased 20-fold between 2015 and 2022. Wait-listed time to receive HCV NAT+ kidneys has been rising and most of the kidneys are transplanted to HCV-naive recipients. The proportion of deceased donor kidney transplants performed in recipients with HCV seropositivity decreased from 5.1 to 2.8% during the same period. Relatively short courses of DAA therapy (7–8 days) appear to be effective to decrease HCV transmission ( 〈 5%) and achieve sustained virological response at 12 weeks if administered prior to revascularization. Summary Further studies are needed to evaluate long-term outcomes of HCV NAT D+/R− transplantation and the best course of DAA treatment.
Type of Medium:
Online Resource
ISSN:
1087-2418
,
1531-7013
DOI:
10.1097/MOT.0000000000001031
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2023
detail.hit.zdb_id:
2026382-X
