Hepatitis C viraemic organs in solid organ transplantation

Weinfurtner, Kelley; Reddy, K. Rajender

doi:10.1016/j.jhep.2020.11.014

Cited by 19 publications

(17 citation statements)

References 68 publications

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“…Viremic donors whose organs are accepted for transplantation are more commonly younger, healthier, less obese, and have a lower kidney donor profile index (KDPI) 17 . Likely from careful donor and recipient selection, post‐transplant recipient outcomes have been similar or better to those of recipients who received aviremic organs 7 …”

Section: Resultsmentioning

confidence: 99%

“…17 Likely from careful donor and recipient selection, post-transplant recipient outcomes have been similar or better to those of recipients who received aviremic organs. 7 Organ quality and the risk of post-transplant dysfunction featured prominently as concerning to both patients and providers in the studies reviewed. Patients expressed concerns that the organ will "not work…”

Section: Organ Quality and Risk Of Organ Dysfunctionmentioning

confidence: 99%

See 1 more Smart Citation

Clinician and patient attitudes toward use of organs from hepatitis C viremic donors and their impact on acceptance: A contemporary review

Fleetwood

Maher

Satish

et al. 2021

Clinical Transplantation

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Background The use of Hepatitis C (HCV) NAT positive allografts remains unusual and is clustered at few centers. We conducted a contemporary literature review to assess whether patient and clinician attitudes toward viremic organs impact acceptance. Methods Databases including PubMed, MEDLINE, and SCOPUS databases were reviewed to identify studies focused on evaluating patient and provider perceptions of HCV NAT positive organ use within the DAA era (January 2015–April 2021). Search included MeSH terms related to Hepatitis C, transplantation, and patient and clinician attitudes. Two investigators extracted study characteristics including information on willingness to accept viremic organs, HCV‐specific outcomes knowledge, HCV‐specific concerns, and factors that contributed to acceptance or non‐acceptance. Results Eight studies met all inclusion criteria. These included three pretransplant patient‐directed studies, two post‐transplant patient‐directed studies, one pre‐ and post‐transplant patient‐directed study, and two clinician‐directed studies. Common themes identified were concerns regarding HCV cure rates, viremic organ quality, DAA cost, stigma, and the possibility of HCV transmission to household members. The perception of decreased waitlist time was associated with viremic organ acceptance. Physician trust played a mixed role in acceptance patterns. Conclusions Knowledge of high cure rates, shorter waitlist times, and higher organ quality appear to have the highest impact on organ acceptance.

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Section: Resultsmentioning

confidence: 99%

Section: Organ Quality and Risk Of Organ Dysfunctionmentioning

confidence: 99%

Clinician and patient attitudes toward use of organs from hepatitis C viremic donors and their impact on acceptance: A contemporary review

Fleetwood

Maher

Satish

et al. 2021

Clinical Transplantation

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“…83 The ability to almost always cure HCV infection with DAA has led to consider transplantation of organs from HCV-positive donors, being not only anti-HCV but also HCV RNA positive. Several studies have shown excellent results in the setting of kidney, liver, heart, and lung transplantations (reviewed in 84 ). Pre-emptive treatment at the time of transplantation 85 or early treatment of acute HCV infection post-transplant 86 results in prevention of transplant hepatitis (reviewed in 84 ).…”

Section: Opportunities Of Hcv Therapymentioning

confidence: 99%

“…Several studies have shown excellent results in the setting of kidney, liver, heart, and lung transplantations (reviewed in 84 ). Pre-emptive treatment at the time of transplantation 85 or early treatment of acute HCV infection post-transplant 86 results in prevention of transplant hepatitis (reviewed in 84 ). Transplantation of HCV-positive organs offers the opportunity to increase the donor pool and thus transplantation rates, thereby reducing mortality on the waiting list.…”

Section: Opportunities Of Hcv Therapymentioning

confidence: 99%

The curing regimens of HCV: A SWOT analysis

Cornberg

Manns

2022

Antiviral Therapy

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The development of direct-acting antivirals (DAA) has revolutionized the treatment of chronic hepatitis C, enabling cure of hepatitis C virus (HCV) infection in more than 95% of cases. There are essentially no contraindications, so almost any patient can now be successfully treated. The result is the prevention or amelioration of cirrhosis, hepatocellular carcinoma (HCC), and extrahepatic manifestations. Consequently, the 2020 Nobel Prize in Medicine and Physiology was awarded for the discovery of HCV. Due to the high efficacy of therapy, even global HCV elimination is conceivable even without a vaccine. Here, we would like to venture a SWOT analysis of current HCV therapies aimed at HCV elimination.

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“…Different series have shown good results in lung, heart[ 138 ] and kidney transplantation. Even in liver transplants[ 139 ], provided the benefit of the transplant exceeded the risk of death on the waiting list, and early access to DAA treatment is guaranteed[ 140 , 141 ].…”

Section: Hepatitis Cmentioning

confidence: 99%

Present and future management of viral hepatitis

Grande¹,

Leiva²,

Ortega³

et al. 2021

WJG

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Viral hepatitis can result in important morbidity and mortality, with its impact on health conditioned by the specific type of hepatitis, the geographical region of presentation and the development and access to new drugs, among other factors. Most acute presentation forms are self-limiting and may even go unnoticed, with just a small percentage of cases leading to acute liver failure that may necessitate transplantation or even cause the death of the patient. However, when they become chronic, as in the case of hepatitis B virus and C virus, unless they are diagnosed and treated adequately they may have severe consequences, like cirrhosis or hepatocarcinoma. Understanding of the mechanisms of transmission, the pathogenesis, the presence of vaccinations and the development over recent years of new highly-efficient, potent drugs have meant that we are now faced with a new scenario in the management of viral hepatitis, particularly hepatitis B virus and hepatitis C virus. The spectacular advances in hepatitis C virus treatment have led the World Health Organization to propose the objective of its eradication by 2030. The key aspect to achieving this goal is to ensure that these treatments reach all the more vulnerable population groups, in whom the different types of viral hepatitis have a high prevalence and constitute a niche that may perpetuate infection and hinder its eradication. Accordingly, micro-elimination programs assume special relevance at the present time.

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Hepatitis C viraemic organs in solid organ transplantation

Cited by 19 publications

References 68 publications

Clinician and patient attitudes toward use of organs from hepatitis C viremic donors and their impact on acceptance: A contemporary review

Clinician and patient attitudes toward use of organs from hepatitis C viremic donors and their impact on acceptance: A contemporary review

The curing regimens of HCV: A SWOT analysis

Present and future management of viral hepatitis

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