A Multi-Center Experience of Direct Acting Anti-Viral Agents in HCV Positive Patients Receiving HCV Positive Livers.
1Gastroenterology, Cleveland Clinic, Weston, FL
2Transplant, Cleveland Clinic, Weston, FL
3Gastroenterology, Cleveland Clinic, Cleveland, OH
Meeting: 2017 American Transplant Congress
Abstract number: 149
Keywords: Hepatitis C, Liver, Liver transplantation, Waiting lists
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: 5:18pm-5:30pm
Location: E271a
Background: HCV cirrhosis is the leading indication for liver transplantation in the U.S. The development of direct acting anti-viral agents (DAAs) has changed the approach to HCV positive grafts. Herein, we present our experience with DAAs in HCV positive patients who receive an HCV positive graft.
Methods: Multi-center, retrospective review of patients from July, 2015 till present. HCV positive patients receiving an HCV positive liver and then treated with DAAs were included.
Results: 20 HCV positive patients received an HCV positive graft. 10 patients have started HCV treatment at the time of this abstract.
| Genotype | Pre-Treatment Viral Load | Treatment Regimen in Weeks | Response | Adverse Events | |
| 1 | 1a | 57100000 | Sofosbuvir/Ledipasvir x12 | SVR | – |
| 2 | 1a/1b | 69100 | Sofosbuvir/Ledipasvir x24 | SVR | – |
| 3 | 1a | 926000 | Sofosbuvir/Ledipasvir/Ribavirin x12 | ETR | Anemia |
| 4 | 1a | 21400000 | Sofosbuvir/Ledipasvir x12 | ETR | Headache |
| 5 | 1a | 1590000 | Sofosbuvir/Ledipasvir x12 | EVR | Fatigue |
| 6 | 1a | 122000 | Sofosbuvir/Ledipasvir/Ribavirin x24 | EVR | – |
| 7 | 3 | 939000 | Daclatasvir/Sofosbuvir/Ribavirin x12 | EVR | – |
| 8 | 1a | 20100000 | Sofosbuvir/Ledipasvir/Ribavirin x12 | EVR | – |
| 9 | 1a | 10000000 | Sofosbuvir/Ledipasvir/Ribavirin x16 | Non-responder | – |
| 10 | 1a | 2040000 | Sofosbuvir/Ledipasvir x12 | EVR | – |
DAAs were initiated an average of 6 months post OLT. All were on Tacrolimus based immunosupression and none required adjustment.
Discussion: Historically, HCV grafts are more likely to be discarded compared to HCV negative grafts. Our series demonstrates a favorable response to Sofosbuvir based regimens. The patients in our series were given anti-virals regardless of graft fibrosis or viral load. Our series is unique in describing empiric initiation of DAAs in HCV patients receiving a HCV graft. While further studies are required to confirm our experience, the remarkable response to DAAs may shift our approach to HCV positive grafts.
CITATION INFORMATION: Kapila N, Zervos B, Ismail B, Lindenmeyer C, Sanghi V, Menon K, Schnickel G, Rivas J, Reino D, Tzakis A. A Multi-Center Experience of Direct Acting Anti-Viral Agents in HCV Positive Patients Receiving HCV Positive Livers. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Kapila N, Zervos B, Ismail B, Lindenmeyer C, Sanghi V, Menon K, Schnickel G, Rivas J, Reino D, Tzakis A. A Multi-Center Experience of Direct Acting Anti-Viral Agents in HCV Positive Patients Receiving HCV Positive Livers. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/a-multi-center-experience-of-direct-acting-anti-viral-agents-in-hcv-positive-patients-receiving-hcv-positive-livers/. Accessed November 25, 2024.« Back to 2017 American Transplant Congress