Use of a hepatitis C virus (HCV) RNA‐positive donor in a treated HCV RNA‐negative liver transplant recipient |
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| Authors: | Isabel Campos‐Varela Eliana Z. Agudelo Monika Sarkar John P. Roberts Norah A. Terrault |
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| Affiliation: | 1. Universidade de Santiago de Compostela (CLINURSID) and Department of Internal Medicine, Hospital of Santiago de Compostela, Santiago de Compostela, Spain;2. Department of Medicine, University of California‐San Francisco, San Francisco, CA, USA;3. Department of Surgery, University of California‐San Francisco, San Francisco, CA, USA |
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| Abstract: | The shortage of livers has led most transplant centers to use extended criteria donors. Hepatitis C virus (HCV) RNA‐positive donor organs are typically not given to patients who have cleared HCV. A 64‐year‐old male with chronic hepatitis C, genotype 1b was listed for LT with hepatocellular carcinoma. While on the waiting list, the patient was treated with sofosbuvir, ledipasvir, and ribavirin and achieved an HCV RNA <15 IU/mL by week 10. At week 18 of a planned 24‐week treatment course, the patient underwent deceased‐donor LT and received an organ from an anti‐HCV‐positive donor. Treatment was stopped at LT. At week 3 post LT, HCV RNA was detectable and revealed a genotype 3 HCV infection, compatible with transplantation of an organ with established infection. With retreatment with sofosbuvir, daclatasvir, and ribavirin for 12 weeks, the patient achieved a sustained virologic response. This report highlights how antiviral therapies can be used to optimize the outcomes of HCV‐infected transplant patients. |
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| Keywords: | antiviral treatment genotype 1 genotype 3 hepatocellular carcinoma sustained virologic response |
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