Utilization of hepatitis C virus-positive donors in kidney transplantation.
Curr Opin Organ Transplant
; 28(1): 22-28, 2023 02 01.
Article
em En
| MEDLINE
| ID: mdl-36227758
ABSTRACT
PURPOSE OF REVIEW 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 7âyears. 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 (7-8âdays) appear to be effective to decrease HCV transmission (<5%) and achieve sustained virological response at 12âweeks 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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transplante de Rim
/
Hepatite C
/
Hepatite C Crônica
Limite:
Humans
Idioma:
En
Revista:
Curr Opin Organ Transplant
Ano de publicação:
2023
Tipo de documento:
Article