Renal transplantation from seropositive hepatitis C virus donors to seronegative recipients in Spain: a prospective study
Por:
Franco, A, Moreso, F, Merino, E, Sancho, A, Kanter, J, Gimeno, A, Balibrea, N, Rodriguez, M and Contreras, F
Publicada:
1 jul 2019
Ahead of Print:
10 mar 2019
Resumen:
Hepatitis C virus (HCV) positive donors are identified in Spain by antibody detection (HCV-Ab) techniques while a HCV nuclear acid-testing (HCV-NAT) is not mandatory. Since it has been shown that HCV-Ab positive HCV-NAT negative donors do not universally transmit the infection, we designed a protocol based on the identification of viremia in HCV-Ab positive donors to start treatment if needed. HCV-Ab-positive donors were identified and we performed HCV-NAT immediately. Donors coinfected with HIV were excluded. Recipients with a low chance to receive a transplant, with no history of liver disease and who were negative for HCV-Ab were selected after informed consent was signed. Kidney recipients from HCV-NAT-positive donors received glecaprevir and pibrentasvir from 6 h before the transplant until 8 weeks after. Recipients from HCV-NAT-negative donors were not treated. Regular monitoring by HCV-NAT was performed to initiate antiviral treatment. We included 11 recipients from six deceased donors Four recipients received grafts from HCV-NAT-positive donors and seven patients received grafts from HCV-NAT-negative donors. None of our recipients exhibited HCV-NAT positivity during the minimum follow-up period of 6 months. Recipients from HCV-NAT-positive donors exhibited sustained virologic response at 12 weeks. One recipient from an HCV-NAT-negative donor lost his graft via a process thought to be unrelated to HCV. The remaining 10 patients had a stable functioning graft at the end of the follow-up period. Our preliminary data suggest that renal transplantation from HCV-Ab- positive donors to HCV-Ab negative recipients is safe when only the recipients of organs from HCV-NAT-positive donors are treated.
Filiaciones:
:
Hosp Gen Alicante, Dept Nephrol, Maestro Alonso 109, Alicante 03010, Spain
Moreso, F:
Hosp Univ Vall Hebron Barcelona, Dept Nephrol, Barcelona, Spain
:
Hosp Gen Alicante, Dept Internal Med, Alicante, Spain
Sancho, A:
Hosp Dr Pesset, Dept Nephrol, Valencia, Spain
Kanter, J:
Hosp Dr Pesset, Dept Nephrol, Valencia, Spain
:
Hosp Gen Alicante, Dept Microbiol, Alicante, Spain
:
Hosp Gen Alicante, Dept Nephrol, Maestro Alonso 109, Alicante 03010, Spain
:
Hosp Gen Alicante, Dept Hepatol, Alicante, Spain
:
Hosp Gen Alicante, Dept Nephrol, Maestro Alonso 109, Alicante 03010, Spain
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