A Single Center's Experience of Direct Acting Anti-Viral Agents in HCV Positive Patients Receiving an HCV Positive Kidney.
1Gastroenterology/Hepatology, Cleveland Clinic, Weston, FL
2Transplant, Cleveland Clinic, Weston, FL
Meeting: 2017 American Transplant Congress
Abstract number: C21
Keywords: Donors, Hepatitis C, Kidney transplantation, marginal, Viral therapy
Session Information
Session Name: Poster Session C: Deceased Donor Issues II: DCD, DGF, AKI, En-Bloc
Session Type: Poster Session
Date: Monday, May 1, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Background: Nearly 8% of patients in the U.S. undergoing hemodialysis are Hepatitis C (HCV) positive. There is a survival benefit in HCV positive patients who receive an HCV positive kidney as opposed to remaining on dialysis. Despite this, HCV positive organs are underutilized. Herein, we present a single center's experience with DAAs in HCV positive patients who receive an HCV positive graft.
Methods: We conducted a retrospective chart review, including patients from March of 2015 till present. Those patients who were HCV positive and received an HCV positive kidney and then treated with DAAs were included.
Results: 8 HCV positive patients received HCV positive grafts. 6 of the 8 patients have started HCV treatment at the time of writing this abstract.
| Genotype | Pre-Treatment Viral Load | Duration of Sofosbuvir/Ledipasvir Therapy | Response to Treatent | |
| 1 | 1b | 245.000 | 12 weeks | SVR |
| 2 | 1a | 1.570.000 | 12 weeks | SVR |
| 3 | 1b | 301,000 | 12 weeks | SVR |
| 4 | 1a | 2,350,000 | 12 weeks | SVR |
| 5 | 1a | 11,400,000 | 12 weeks | ETR |
| 6 | 2b | 66,700 | 12 weeks | n/a |
Anti-viral therapy was initiated at a median of 12 weeks post kidney transplantation. All patients were on a Tacrolimus, Prednisone, and Mycophenolate Mofetil based immunosuppression regimen. 1 patient required adjustment of their Tacrolimus due to interaction with the anti-viral therapy.
Discussion: HCV positive kidneys remain underutilized. Considering the overall benefit of receiving an HCV positive graft over remaining on dialysis, there is opportunity to expand the donor pool, decrease wait times, and improve survival. Our case series demonstrates a remarkable response to Sofosbuvir based anti-viral regimens when used in HCV positive patients receiving HCV positive kidneys. The patients in our case series were given empiric anti-HCV treatment regardless of degree of liver fibrosis or viral load. Our particular case series is unique in that it describes the empiric initiation of DAAs in HCV positive patients receiving an HCV positive graft. While further studies are required to confirm our experience, the remarkable response to DAAs may further change our approach to HCV positive grafts.
CITATION INFORMATION: Kapila N, Zervos B, Ismail B, Schnickel G, Rivas J, Reino D, Agrawal N, Tzakis A. A Single Center's Experience of Direct Acting Anti-Viral Agents in HCV Positive Patients Receiving an HCV Positive Kidney. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Kapila N, Zervos B, Ismail B, Schnickel G, Rivas J, Reino D, Agrawal N, Tzakis A. A Single Center's Experience of Direct Acting Anti-Viral Agents in HCV Positive Patients Receiving an HCV Positive Kidney. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/a-single-centers-experience-of-direct-acting-anti-viral-agents-in-hcv-positive-patients-receiving-an-hcv-positive-kidney/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress