CROI 2018—Transplants from hepatitis C-infected donors successful


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Takeaway

  • Noninfected patients do well after receiving donor organs from hepatitis C-infected individuals

Why this matters

  • Thousands of patients die waiting for donor organs, and using the organs of patients with hepatitis C, who mostly die from overdoses, can shorten the wait time for a kidney and shorten the waitlist.
  • There are now 24 centers in the United States that have indicated a desire to perform these transplants.

Key results

  • Of 10 patients in the EXPANDER trial who received kidneys from donors who were infected with hepatitis C, all have patent grafts and are free of hepatitis C at 1 year.

Study design

  • Patients who receive the transplanted organ undergo a prophylactic protocol with direct-acting antivirals.
  • Patients receiving kidneys from patients with hepatitis C genotype 1 or 4 were treated with a combination of grazoprevir and elbasvir for 12 weeks.
  • Those receiving kidneys from patients infected with hepatitis C genotype 2 or 3 also were treated with sofosbuvir for 12 weeks.

Limitations

  • There are small numbers of patients in the pilot study.
  • The transplants from infected patients to noninfected patients can only be performed under research protocols.

Expert comment

  • "People need more options because people are dying while on these waiting lists. We need to think of all possibilities and the chance of clearing hepatitis C is so easily done that it makes this very attractive," said Jurgen Rockstroh, MD, professor of medicine at the University of Bonn, Germany, who was not involved in the study.