Transplanting Livers From Donors With HCV Is Safe in the Era of Highly Effective Direct-Acting Antivirals: Presented at EASL

By Alex Morrisson

VIENNA, Austria -- April 17, 2019 -- Transplanting livers that are infected with the hepatitis C virus (HCV) to recipients that do not have HCV is safe in the era of highly effective direct-acting antiviral (DAA) therapy, researchers reported here at The International Liver Meeting, the 54th Annual Meeting of the European Association for the Study of the Liver (EASL).

In 23 patients who were on the waitlist for a liver, and who received livers from patients with HCV, all recipients developed HCV themselves. However, treatment with DAAS was started within 19 days to 138 days after transplantation surgery.

“At this time, 16 recipients have completed treatments for hepatitis C using these treatments and 15 patients have achieved a sustained viral response 12 weeks post-treatment,” said Heather O’Dell, Vanderbilt University Medical Center, Nashville, Tennessee.

The data on the 16th patient who has completed therapy is pending and 5 recipients are in the midst of DAA treatment. Two other recipients are waiting to start therapy.

“All transplanted recipients in this cohort are recovering expectedly,” said O’Dell.

Transplant recipients received treatment with ledipasvir/sofosbuvir, glecaprevir/pibrentasvir, or sofosbuvir/velpatasvir.

“Hepatitis C-uninfected patients on the liver waitlist transplanted with hepatitis C-infected grafts universally develop infection with hepatitis C post-transplant,” said O’Dell. “Fortunately, these patients can be cleared of hepatitis C post-transplant.”

“In the short-term follow-up, patients who receive HCV-infected grafts do not have a higher mortality than non-infected liver transplant recipients who receive non-infected donor grafts,” she added.

The patients who were going to receive an HCV-infected organ were given the opportunity of consenting to receive the graft. O’Dell noted that aside from the donor organ having HCV, it was otherwise suitable as a donor organ.

[Presentation title: Hepatitis C Infected Liver Grafts Transplanted Into Non-Infected Recipients Are Safe in the Era of Highly Effective Direct-Acting Antiviral Therapy. Abstract FRI-388]

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