Hepatitis C-positive donor liver transplantation for hepatitis C seronegative recipients

Research output: Contribution to journalArticle

Abstract

Background: The opioid crisis has led to an increase in hepatitis C virus-positive donors in the past decade. Whereas historically hepatitis C seropositive organs were routinely discarded, the advent of direct-acting antiviral agents has notably expanded the utilization of organs from donors with hepatitis C. There has been growing experience with liver transplantation (LT) from hepatitis C seropositive donors to hepatitis C seropositive recipients. However, data remain limited on LT from hepatitis C seropositive or hepatitis C ribonucleic acid positive donors to hepatitis C seronegative recipients. Methods: We performed a retrospective study of 26 hepatitis C seronegative recipients who received hepatitis C seropositive donor livers followed by preemptive antiviral therapy with direct-acting antiviral treatment at the Johns Hopkins Hospital Comprehensive Transplant Center from January 1, 2017, to August 31, 2019. Results: Twenty-five of the 26 recipients are alive with proper graft function; 20 of them received livers from hepatitis C nucleic acid testing positive donors. All 12 recipients who completed their direct-acting antiviral courses and have reached sufficient follow-up for sustained virologic response have achieved sustained virologic response. Nine of our recipients have either completed direct-acting antiviral treatment without sufficient follow-up time for sustained virologic response or are undergoing direct-acting antiviral treatment. One patient is awaiting antiviral treatment initiation pending insurance approval. Of note, 11 of 12 patients with sustained virologic response received a hepatitis C nucleic acid testing positive donor liver. Conclusion: Hepatitis C seronegative patients who receive a hepatitis C seropositive or hepatitis C nucleic acid testing positive liver allograft can enjoy good short-term outcomes with hepatitis C cure following direct-acting antiviral treatment.

Original languageEnglish (US)
Article numbere13194
JournalTransplant Infectious Disease
DOIs
StateAccepted/In press - Jan 1 2019

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Hepatitis C
Liver Transplantation
Tissue Donors
Antiviral Agents
Nucleic Acids
Liver
Therapeutics
Transplants
Insurance
Hepacivirus
Opioid Analgesics
Allografts

Keywords

  • direct-acting antiviral
  • hepatitis C virus-negative recipient
  • hepatitis C virus-positive donor liver
  • liver transplantation
  • preemptive antiviral therapy

ASJC Scopus subject areas

  • Infectious Diseases
  • Transplantation

Cite this

@article{e910da79e28848ad85d96a2d1e46fc15,
title = "Hepatitis C-positive donor liver transplantation for hepatitis C seronegative recipients",
abstract = "Background: The opioid crisis has led to an increase in hepatitis C virus-positive donors in the past decade. Whereas historically hepatitis C seropositive organs were routinely discarded, the advent of direct-acting antiviral agents has notably expanded the utilization of organs from donors with hepatitis C. There has been growing experience with liver transplantation (LT) from hepatitis C seropositive donors to hepatitis C seropositive recipients. However, data remain limited on LT from hepatitis C seropositive or hepatitis C ribonucleic acid positive donors to hepatitis C seronegative recipients. Methods: We performed a retrospective study of 26 hepatitis C seronegative recipients who received hepatitis C seropositive donor livers followed by preemptive antiviral therapy with direct-acting antiviral treatment at the Johns Hopkins Hospital Comprehensive Transplant Center from January 1, 2017, to August 31, 2019. Results: Twenty-five of the 26 recipients are alive with proper graft function; 20 of them received livers from hepatitis C nucleic acid testing positive donors. All 12 recipients who completed their direct-acting antiviral courses and have reached sufficient follow-up for sustained virologic response have achieved sustained virologic response. Nine of our recipients have either completed direct-acting antiviral treatment without sufficient follow-up time for sustained virologic response or are undergoing direct-acting antiviral treatment. One patient is awaiting antiviral treatment initiation pending insurance approval. Of note, 11 of 12 patients with sustained virologic response received a hepatitis C nucleic acid testing positive donor liver. Conclusion: Hepatitis C seronegative patients who receive a hepatitis C seropositive or hepatitis C nucleic acid testing positive liver allograft can enjoy good short-term outcomes with hepatitis C cure following direct-acting antiviral treatment.",
keywords = "direct-acting antiviral, hepatitis C virus-negative recipient, hepatitis C virus-positive donor liver, liver transplantation, preemptive antiviral therapy",
author = "Ting, {Peng sheng} and Hamilton, {James Peter} and Ahmet Gurakar and Urrunaga, {Nathalie H.} and Michelle Ma and Jaime Glorioso and Elizabeth King and Toman, {Lindsey P.} and Russell Wesson and Jacqueline Garonzik-Wang and Shane Ottmann and Benjamin Philosophe and Mark Sulkowski and Cameron, {Andrew M.} and Durand, {Christine M.} and Chen, {Po Hung}",
year = "2019",
month = "1",
day = "1",
doi = "10.1111/tid.13194",
language = "English (US)",
journal = "Transplant Infectious Disease",
issn = "1398-2273",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Hepatitis C-positive donor liver transplantation for hepatitis C seronegative recipients

AU - Ting, Peng sheng

AU - Hamilton, James Peter

AU - Gurakar, Ahmet

AU - Urrunaga, Nathalie H.

AU - Ma, Michelle

AU - Glorioso, Jaime

AU - King, Elizabeth

AU - Toman, Lindsey P.

AU - Wesson, Russell

AU - Garonzik-Wang, Jacqueline

AU - Ottmann, Shane

AU - Philosophe, Benjamin

AU - Sulkowski, Mark

AU - Cameron, Andrew M.

AU - Durand, Christine M.

AU - Chen, Po Hung

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: The opioid crisis has led to an increase in hepatitis C virus-positive donors in the past decade. Whereas historically hepatitis C seropositive organs were routinely discarded, the advent of direct-acting antiviral agents has notably expanded the utilization of organs from donors with hepatitis C. There has been growing experience with liver transplantation (LT) from hepatitis C seropositive donors to hepatitis C seropositive recipients. However, data remain limited on LT from hepatitis C seropositive or hepatitis C ribonucleic acid positive donors to hepatitis C seronegative recipients. Methods: We performed a retrospective study of 26 hepatitis C seronegative recipients who received hepatitis C seropositive donor livers followed by preemptive antiviral therapy with direct-acting antiviral treatment at the Johns Hopkins Hospital Comprehensive Transplant Center from January 1, 2017, to August 31, 2019. Results: Twenty-five of the 26 recipients are alive with proper graft function; 20 of them received livers from hepatitis C nucleic acid testing positive donors. All 12 recipients who completed their direct-acting antiviral courses and have reached sufficient follow-up for sustained virologic response have achieved sustained virologic response. Nine of our recipients have either completed direct-acting antiviral treatment without sufficient follow-up time for sustained virologic response or are undergoing direct-acting antiviral treatment. One patient is awaiting antiviral treatment initiation pending insurance approval. Of note, 11 of 12 patients with sustained virologic response received a hepatitis C nucleic acid testing positive donor liver. Conclusion: Hepatitis C seronegative patients who receive a hepatitis C seropositive or hepatitis C nucleic acid testing positive liver allograft can enjoy good short-term outcomes with hepatitis C cure following direct-acting antiviral treatment.

AB - Background: The opioid crisis has led to an increase in hepatitis C virus-positive donors in the past decade. Whereas historically hepatitis C seropositive organs were routinely discarded, the advent of direct-acting antiviral agents has notably expanded the utilization of organs from donors with hepatitis C. There has been growing experience with liver transplantation (LT) from hepatitis C seropositive donors to hepatitis C seropositive recipients. However, data remain limited on LT from hepatitis C seropositive or hepatitis C ribonucleic acid positive donors to hepatitis C seronegative recipients. Methods: We performed a retrospective study of 26 hepatitis C seronegative recipients who received hepatitis C seropositive donor livers followed by preemptive antiviral therapy with direct-acting antiviral treatment at the Johns Hopkins Hospital Comprehensive Transplant Center from January 1, 2017, to August 31, 2019. Results: Twenty-five of the 26 recipients are alive with proper graft function; 20 of them received livers from hepatitis C nucleic acid testing positive donors. All 12 recipients who completed their direct-acting antiviral courses and have reached sufficient follow-up for sustained virologic response have achieved sustained virologic response. Nine of our recipients have either completed direct-acting antiviral treatment without sufficient follow-up time for sustained virologic response or are undergoing direct-acting antiviral treatment. One patient is awaiting antiviral treatment initiation pending insurance approval. Of note, 11 of 12 patients with sustained virologic response received a hepatitis C nucleic acid testing positive donor liver. Conclusion: Hepatitis C seronegative patients who receive a hepatitis C seropositive or hepatitis C nucleic acid testing positive liver allograft can enjoy good short-term outcomes with hepatitis C cure following direct-acting antiviral treatment.

KW - direct-acting antiviral

KW - hepatitis C virus-negative recipient

KW - hepatitis C virus-positive donor liver

KW - liver transplantation

KW - preemptive antiviral therapy

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U2 - 10.1111/tid.13194

DO - 10.1111/tid.13194

M3 - Article

C2 - 31609520

AN - SCOPUS:85074840299

JO - Transplant Infectious Disease

JF - Transplant Infectious Disease

SN - 1398-2273

M1 - e13194

ER -