AUTHOR=Doherty Daniel T. , Athwal Varinder , Moinuddin Zia , Augustine Titus , Prince Martin , van Dellen David , Khambalia Hussein A. 

TITLE=Kidney Transplantation From Hepatitis-C Viraemic Donors:Considerations for Practice in the United Kingdom

JOURNAL=Transplant International

VOLUME=Volume 35 - 2022

YEAR=2022

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2022.10277

DOI=10.3389/ti.2022.10277

ISSN=1432-2277

ABSTRACT=Background: Donor hepatitis-C (HCV) infection has historically represented a contra-indication to kidney transplantation (KT). However, direct-acting antiviral (DAA) medications have revolutionised treatment of chronic HCV infection. Recent American studies have demonstrated that DAA regimes can be used safely peri-operatively in KT to mitigate HCV transmission risk.
Methods: a comprehensive literature was performed to analysis results of existing clinical trials examining KT from HCV-positive donors to HCV-negative recipients with peri-operative DAA regimes.
Results: 11 studies were reviewed (9 single centre, 4 retrospective). Outcomes for 244 recipients were available across these studies. A sustained virological response at 12 weeks (SVR12) of 100% was achieved in 9 studies. One study employed an ultra-short DAA regime and achieved an SVR12 of 98%, while another achieved SVR12 of 96% due to treatment of a missed mixed genotype.
Conclusion: HCV+ KT is safe and may allow increased utilisation of organs for transplantation from HCV+ donors, who often have other favourable characteristics for successful donation. Findings from US clinical trials can be applied to the UK transplant framework to improve organ utilisation as suggested by The NHSBT vision strategy ‘Organ Donation and Transplantation 2030: meeting the need’.