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Use of Hepatitis C Viremic Donors to Expand the Pediatric Donor Pool
Natasha Dilwali1, Christopher Hartley2, Paul K Sue3
1Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Johns Hopkins University of Medicine, Baltimore, MD 21287, USA.
Insights
Organ transplants from hepatitis C virus (HCV)-positive donors are increasingly safe and effective for recipients, thanks to direct-acting antiviral (DAA) therapies, helping to expand the donor pool.
Area of Science:
- Transplantation Medicine
- Infectious Diseases
- Virology
Background:
- Direct-acting antiviral (DAA) therapies offer high cure rates for hepatitis C virus (HCV).
- Advancements in DAAs make using HCV-positive donors for organ transplantation increasingly viable.
- Organ shortage remains a critical issue in transplantation.
Purpose of the Study:
- To review current practices, benefits, and challenges of using HCV-positive donors in organ transplantation.
- To evaluate the safety and efficacy of transplanting organs from HCV-positive donors.
- To explore ethical considerations and future protocols for HCV-positive donor transplantation.
Main Methods:
- Literature review of recent studies and clinical data.
- Analysis of transplant center practices regarding HCV-positive donors.
- Evaluation of post-transplant outcomes and antiviral treatment efficacy.
Main Results:
- Transplant centers are increasingly accepting HCV-positive donors for kidneys, livers, and hearts.
- Utilizing HCV-positive donors expands the donor pool and reduces waitlist times.
- Transplantation from HCV-positive to HCV-negative recipients is safe and effective with proper management, showing excellent graft function and survival.
Conclusions:
- HCV-positive donor transplantation, when managed with post-transplant DAA therapy, effectively addresses organ shortages.
- Key considerations include viral transmission, long-term outcomes, cost-effectiveness, and ethical implications.
- Optimized protocols are essential for the future of HCV-positive donor organ transplantation.
Abstract:
The use of hepatitis C virus (HCV)-positive donors in organ transplantation has become increasingly viable due to advancements in direct-acting antiviral (DAA) therapies, which offer high cure rates. This review aims to evaluate the current practices, benefits, and challenges of utilizing HCV-positive donors for organ transplantation. The recent data show that transplant centers are progressively accepting HCV-positive donors for various organs, including kidneys, livers, and hearts, given the efficacy of post-transplant antiviral treatment. Using these donors has helped mitigate the organ shortage crisis, increasing the donor pool and reducing waitlist times. Despite these advantages, the approach raises concerns about viral transmission, long-term outcomes, and the cost-effectiveness of post-transplant DAA therapy. Furthermore, this review highlights the ethical implications of informed consent and the monitoring of HCV-negative recipients following transplantation. The outcomes from recent studies suggest that with proper management, transplantations from HCV-positive donors to HCV-negative recipients can be safe and effective, leading to excellent graft function and patient survival. This review synthesizes existing research and offers insights into optimizing protocols for future transplants involving HCV-positive donors.
