New insights into the rational use of HCV+ organs worldwide

Clin Transplant. 2019 Dec;33(12):e13739. doi: 10.1111/ctr.13739. Epub 2019 Nov 8.

Abstract

Hepatitis C (HCV) is a worldwide health problem. Effective therapies for HCV infection, coupled with an increase in deceased donors due to the opioid epidemic, have led to the broader availability and the use of HCV-infected donor organs, including HCV nucleic acid test-positive (NAT+) donors in HCV-negative recipients. In this review, we discuss the prevalence of HCV infection, trends in the use of HCV-infected donors, and outcomes for those who receive HCV-seropositive or HCV NAT+ donor organs. We discuss management considerations such as hepatitis B reactivation, selection of the optimal direct-acting antiviral regimen, and potential complications. We also present a framework for the rational use of HCV-infected donor organs in the future.

Keywords: heart transplant; hepatitis C; kidney transplant; liver transplant; lung transplant.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / therapeutic use
  • Donor Selection / standards*
  • Hepacivirus / isolation & purification*
  • Hepatitis C / drug therapy
  • Hepatitis C / transmission*
  • Hepatitis C / virology
  • Humans
  • Organ Transplantation / standards*
  • Tissue Donors / supply & distribution*
  • Tissue and Organ Procurement / standards*

Substances

  • Antiviral Agents