Reappraisal of the hepatitis C virus-positive donor in solid organ transplantation

Area of Science:

• Hepatology
• Transplant Surgery
• Virology

Background:

• Hepatitis C virus (HCV) is a major factor in liver transplantation and a comorbidity in non-liver solid organ transplant candidates.
• HCV-positive patients on transplant waitlists face poorer outcomes than those without HCV, though post-transplant survival is better than remaining on the waitlist.

Purpose of the Study:

• To review the utilization of HCV-positive donor allografts in solid organ transplantation.
• To analyze the impact of evolving HCV treatments on the use of these allografts.

Main Methods:

• Literature review of studies on HCV-positive donor allografts in solid organ transplantation.
• Analysis of transplant outcomes in recipients of HCV-positive versus HCV-negative allografts.
• Evaluation of the influence of new direct-acting antiviral (DAA) therapies on HCV management post-transplant.

Main Results:

• HCV-positive allografts are underutilized despite comparable outcomes to HCV-negative allografts in select recipients.
• Transplant recipients accepting HCV-positive donors show outcomes similar to those receiving HCV-negative donors.
• Recent advancements in HCV treatment offer improved efficacy and reduced side effects, enhancing patient outcomes.

Conclusions:

• The use of select HCV-positive donor allografts in solid organ transplantation should be encouraged.
• Improved HCV treatments and reduced transplant wait times support the expanded use of HCV-positive donors.
• This strategy can increase organ availability and improve outcomes for HCV-positive transplant candidates.