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)
Article numbere14381
JournalClinical Transplantation
Volume35
Issue number8
DOIs
StatePublished - Aug 2021

All Science Journal Classification (ASJC) codes

  • Transplantation

Keywords

  • abdominal transplantation
  • hepatitis C donor
  • thoracic transplantation

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