Assessment of Attitudes Toward Use of Hepatitis C Positive Liver Allografts in US Transplant Centers.

S. Kilaru,¹ E. Tapper,² M. Curry.³

¹Medicine, NYU School of Medicine, New York, NY
²Medicine, University of Michigan, Ann Arbor, MI
³Medicine, Beth Israel Deaconess Medical Center, Boston, MA

Meeting: 2017 American Transplant Congress

Abstract number: 148

Keywords: Allocation, Hepatitis C, Liver transplantation, Viral therapy

Session Information

Session Name: Concurrent Session: Liver: Viral Hepatitis

Session Type: Concurrent Session

Date: Sunday, April 30, 2017

Session Time: 4:30pm-6:00pm

Presentation Time: 5:06pm-5:18pm

Location: E271a

Background:

Direct-acting antivirals (DAAs) have been shown to have high cure rates in hepatitis C (HCV)-positive liver transplantation (LT) recipients. The organ donor shortage has led to the use of HCV-positive allografts in HCV-positive recipients, as well as possible use in HCV-negative recipients. The aim of this study is to determine current attitudes of transplant programs towards the use of HCV-positive allografts.

Methods:

This was a descriptive, cross-sectional study utilizing a web based-survey sent to all liver transplant programs in the United States.

Results:

We polled 117 transplant centers and received 46 responses. One incomplete response was excluded from analysis.

Respondents were 82% male and 18% female, and were comprised of 61% physicians and 39% surgeons. All UNOS regions were represented, except for regions 4 and 6. The majority of programs had transplanted more than 51 livers per year, with HCV being the leading indication. Overall, 83% of respondents had a formal program policy on the use of HCV-positive allografts, and 96% of respondents have already used them. Of these 44 respondents, 7 programs would consider using an HCV-positive allograft in an HCV-negative candidate, and 7 have intentionally done so.

Currently 98% of respondents treat HCV-positive LT recipients with DAAs. Respondents were more likely to consider use of HCV-positive allografts in HCV-negative recipients in situations where recipients had a higher degree of illness severity (table 1). The most important nullifying factors in using an HCV-positive allograft in an HCV-negative recipient identified by transplant program directors were related to recipient concerns and concern about severe early recurrent hepatitis.

Table 1. Willingness of programs to use an HCV+ allograft in an HCV-candidate, by listing status.

Status 1	%
Yes	35
No	46
MELD>35
Yes	22
No	65
MELD>25<35
Yes	7
No	82
MELD<25
Yes	0
No	93
HCC not meeting criteria for exception points
Yes	16
No	73

Conclusions:

Though many programs have a formal policy on the use of HCV-positive allografts, and several have used them in HCV-positive recipients, use of HCV-positive allografts in HCV-negative recipients is not yet widespread.

CITATION INFORMATION: Kilaru S, Tapper E, Curry M. Assessment of Attitudes Toward Use of Hepatitis C Positive Liver Allografts in US Transplant Centers. Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Kilaru S, Tapper E, Curry M. Assessment of Attitudes Toward Use of Hepatitis C Positive Liver Allografts in US Transplant Centers. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/assessment-of-attitudes-toward-use-of-hepatitis-c-positive-liver-allografts-in-us-transplant-centers/. Accessed November 22, 2024.

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