Expanding access to transplantation with hepatitis C-positive donors: A new perspective on an old issue

Clin Transplant. 2017 Feb;31(2). doi: 10.1111/ctr.12884.

Abstract

With the need for organs far exceeding supply, donors previously exposed to hepatitis B (HBV) and hepatitis C (HCV) viral infections should be considered for transplantation. Although many centers have protocols for transplanting organs from HBV core antibody-positive (HBcAb+) donors into select recipients, in the era of direct-acting antivirals (DAAs), a new focus should be placed on HCV-positive donors. The transmission rate from HCV antibody-positive (HCVAb+) nucleic acid testing negative (HCV NAT-) donors is expected to be very low, and we encourage use of such organs in HCV recipients provided a normal biopsy, appropriate counseling, and careful post-transplant monitoring. While transmission of HCV from HCV NAT+ donors is universal, the success of DAA in obtaining a sustained viral response in post-transplant recipients should make the use of these organs more appealing. We herein provide information to help guide the use of organs from HCV donors.

Keywords: hepatitis C donor; liver transplant; organ shortage.

MeSH terms

  • Hepacivirus / physiology*
  • Hepatitis C / drug therapy
  • Hepatitis C / transmission*
  • Hepatitis C / virology
  • Humans
  • Organ Transplantation / statistics & numerical data*
  • Prognosis
  • Tissue Donors / supply & distribution*
  • Tissue and Organ Procurement / methods*