Early outcomes using hepatitis C–positive donors for cardiac transplantation in the era of effective direct-acting anti-viral therapies

Schlendorf, Kelly; Zalawadiya, Sandip; Shah, Ashish S.; Wigger, M.; Chung, Chan Y.; Smith, Sinéad M.; Danter, Matthew; Choi, Chun Woo; Keebler, Mary; Brinkley, D.; Sacks, Suzanne Brown; Ooi, Henry; Perri, Roman E.; Awad, Joseph; Lewis, Samuel E.; Hayes, Rachel M.; O’Dell, Heather; Darragh, C.; Carver, Alicia; Edmonds, Cori; Ruzevich-Scholl, S.; Lindenfeld, Jo Ann

doi:10.1016/j.healun.2018.01.1293

Cited by 164 publications

(103 citation statements)

References 28 publications

Supporting

Mentioning

103

Contrasting

Order By: Relevance

“…[24][25][26][27][28] to be closely monitored in controlled, prospective settings to ensure long-term safety, tolerability, and efficacy, as recommended by the AST consensus conference. [24][25][26][27][28] to be closely monitored in controlled, prospective settings to ensure long-term safety, tolerability, and efficacy, as recommended by the AST consensus conference.…”

Section: Discussionmentioning

confidence: 99%

Liver transplantation for hepatitis C virus (HCV) non-viremic recipients with HCV viremic donors

Kwong

Wall

Melcher

et al. 2019

American Journal of Transplantation

113

131

View full text Add to dashboard Cite

| INTRODUC TI ONThe demand for liver transplantation continues to outpace the supply of donor organs in the United States. 1 In the context of this organ shortage, it is essential to make the best use of all transplantable organs. Previously, donor livers infected with hepatitis C virus (HCV) typically have been either discarded or used in patients already infected with HCV. 2-4 Donor livers infected with HCV are still not widely accepted for non-viremic recipients, due to concerns regarding HCV transmission, the natural history of untreated HCV infection after liver transplantation, and limited evidence in this specific population. 5 Highly effective and well-tolerated direct-acting antiviral (DAA) therapies are now available for the treatment of HCV infection and can eliminate HCV in the allograft in greater than 95% of cases. 6In the setting of the ongoing organ shortage, the opioid epidemic, and the advent of DAA therapy, more HCV-infected donor organs are being utilized to expand the donor pool, and non-viremic patients are being given the option to accept these grafts in some centers, including ours. 4,7,8 The aim of our study was to summarize the posttransplant outcomes after donor-derived HCV infection in non-viremic liver transplant recipients at our institution.

show abstract

Section: Discussionmentioning

confidence: 99%

Liver transplantation for hepatitis C virus (HCV) non-viremic recipients with HCV viremic donors

Kwong

Wall

Melcher

et al. 2019

American Journal of Transplantation

113

131

View full text Add to dashboard Cite

show abstract

“…Hence, even though formation of anti‐HCV antibodies in patients with CF‐LVADs has previously been demonstrated, our study is the first to demonstrate 100% antibody clearance and hence provide mechanistic evidence for formation of false positive anti‐HCV antibodies. Our findings may also have indirect implications for the contemporary practice of using HCV‐positive donor hearts for transplant and for interpreting and managing seroconversion in recipients of those donor hearts …”

Section: Discussionmentioning

confidence: 95%

Seroreversion of positive anti‐hepatitis C virus antibodies in left ventricular assist device recipients: Now you see them, now you don’t

et al. 2019

View full text Add to dashboard Cite

The clinical significance of positive anti‐hepatitis C virus (anti‐HCV) antibody tests in recipients of left ventricular assist devices remains unclear. In light of emerging evidence suggesting the possibility of persistent low‐level HCV infection in patients with positive anti‐HCV antibody test but negative HCV ribonucleic acid, it is very important to distinguish the truly false positive HCV antibodies, in recipients of continuous flow left ventricular assist devices, from those suggestive of a prior clinically resolved infection or one where a low‐level viremia may have persisted. We conducted a retrospective analysis of left ventricular assist device recipients at our institution. While the total incidence of positive HCV antibody with concomitantly negative HCV ribonucleic acid test (19.2%) was in keeping with the incidences reported in prior cross‐sectional studies, we longitudinally followed our patients and observed a 100% seroreversion. Seroreversion, which has not been reported in other studies, occurred either during continued left ventricular assist device support (10 out of 26) or after heart transplant (7 out of 26). Hundred percent seroreversion strongly suggested that the anti‐HCV antibodies were truly false positive.

show abstract

“…Since then, other centers have presented or published results of 124 HCV D + /R − transplants (97 HCV NAT + ) now totaling 55 heart, 40 liver, 20 kidney, 7 lung, and 2 heart/kidney grafts (Table ) . Several DAA regimens were used against multiple HCV genotypes, resulting in universal prevention or SVR12 in all treated patients with sufficient follow‐up.…”

Section: Hcv+ Organs Are Increasingly Available Yet Frequently Discardedmentioning

confidence: 99%

Pro: Use of Hepatitis C Virus–Positive Donors Should Be Considered Standard of Care

Werbel

Durand

2018

Clinical Liver Disease

View full text Add to dashboard Cite

show abstract

Early outcomes using hepatitis C–positive donors for cardiac transplantation in the era of effective direct-acting anti-viral therapies

Cited by 164 publications

References 28 publications

Liver transplantation for hepatitis C virus (HCV) non-viremic recipients with HCV viremic donors

Liver transplantation for hepatitis C virus (HCV) non-viremic recipients with HCV viremic donors

Seroreversion of positive anti‐hepatitis C virus antibodies in left ventricular assist device recipients: Now you see them, now you don’t

Pro: Use of Hepatitis C Virus–Positive Donors Should Be Considered Standard of Care

Contact Info

Product

Resources

About