Hepatitis C virus and nonliver solid organ transplantation

Area of Science:

• Hepatology
• Transplant Surgery
• Infectious Diseases

Background:

• Hepatitis C virus (HCV) infection poses significant risks for solid organ allograft recipients, contributing to morbidity and mortality.
• Effective management of HCV in transplant candidates and recipients is essential for improving post-transplant outcomes.

Purpose of the Study:

• To review the scope of HCV infection in organ donors and recipients (kidney, heart, lung).
• To recommend follow-up and treatment strategies for HCV in the context of solid organ transplantation.
• To evaluate current and emerging diagnostic and therapeutic approaches for HCV in transplant populations.

Main Methods:

• Literature review focusing on HCV infection in solid organ transplantation.
• Analysis of outcomes for HCV-infected recipients and outcomes of transplantation using HCV-positive donors.
• Evaluation of diagnostic methods (Fibroscan, serologic measures, nucleic acid amplification testing, HCV core antigen assays) and antiviral therapies.

Main Results:

• Kidney transplantation is feasible for select patients with end-stage kidney disease or early cirrhosis.
• Transplanting kidneys from HCV-positive donors to HCV-positive recipients is safe and reduces wait times.
• HCV antiviral therapy is recommended for HCV-RNA-positive kidney transplant candidates; protease inhibitors require further evaluation in renal dysfunction.

Conclusions:

• HCV management in solid organ transplant recipients requires tailored follow-up and treatment strategies.
• Utilizing HCV-positive donors for HCV-positive recipients can optimize organ allocation.
• Further research is needed on antiviral therapies, particularly protease inhibitors, in transplant patients with renal impairment.