Balancing the risk and rewards of utilizing organs from hepatitis C viremic donors

Area of Science:

• Organ transplantation
• Hepatitis C virus (HCV) infection
• Direct-acting antiviral (DAA) therapy

Background:

• Long waitlist times and high morbidity/mortality associated with organ transplantation.
• Increasing need for strategies to expand the donor organ pool.
• Hepatitis C virus (HCV) viremic organs represent a potential, underutilized resource.

Purpose of the Study:

• To review the risks and rewards of utilizing HCV viremic organs for transplantation.
• To investigate strategies for increasing the utilization of HCV viremic-deceased donor organs.
• To evaluate the safety and efficacy of direct-acting antiviral (DAA) therapy in recipients of HCV viremic organs.

Main Methods:

• Review of current literature on HCV viremic organ transplantation.
• Analysis of outcomes from small, single-center trials using DAA therapy post-transplant.
• Assessment of DAA medication efficacy and tolerability in transplant recipients.

Main Results:

• Direct-acting antiviral (DAA) medications demonstrate high cure rates for HCV infection and are well-tolerated.
• Small trials show 100% cure rates in uninfected recipients of HCV viremic organs treated with early post-transplant DAA therapy.
• Successful outcomes reported in kidney and heart transplant recipients.

Conclusions:

• Utilizing HCV viremic organs is a viable strategy to increase organ availability.
• Early post-transplant DAA therapy is highly effective in preventing or curing HCV infection in recipients.
• This approach can improve transplant rates and patient survival by mitigating waitlist challenges.