Excellent Outcomes for HCV-Viremic Recipients of Simultaneous Liver-Kidney Transplant in the Direct Anti-Viral Era
Piedmont Transplant Institute, Piedmont Healthcare, Atlanta, GA.
Meeting: 2018 American Transplant Congress
Abstract number: C227
Keywords: Hepatitis C, Kidney/liver transplantation, Outcome, Safety
Session Information
Session Name: Poster Session C: Liver: Recipient Selection
Session Type: Poster Session
Date: Monday, June 4, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Before the era of direct anti-viral agents (DAAs), outcomes for HCV-viremic recipients of simultaneous liver kidney transplant (SLKT) were inferior to HCV-negative recipients. PURPOSE: To evaluate HCV, patient, and graft outcomes for HCV-viremic SLKT recipients compared to HCV-negative SLKT recipients. METHODS: A single center retrospective review of outcomes in all SLKT recipients. RESULTS: From 2007-2016, 88 patients underwent SLKT; 20 (22.7%) were HCV-viremic at time of transplant. HCV-viremic recipients were primarily male (75%), Caucasian (75%), and received HCV-negative organs (90%). Most had genotype 1a (65%), 3a (15%) or 1b (10%) HCV; 11/20 (55%) were HCV-treatment naïve. All received basiliximab induction at time of SLKT. 18/20 (90%) of the HCV-viremic patients received DAA treatment post-SLKT; two were lost to follow-up before availability of DAA therapy. Time from transplant to DAA therapy varied (mean 45.4±36.6 months) and was largely dependent upon time interval from transplant to DAA availability. The majority of treated patients received ledipasvir/sofosbuvir with (8/18, 44.4%) or without (5/18, 27.7%) ribavirin. Treatment duration was 12 weeks in 8/18 patients and 24 weeks in 10/18 patients. Of patients ≥12 weeks post-treatment, 12/12 (100%) achieved sustained virologic response (SVR12). Five patients have undergone HCV treatment but have not yet reached SVR12 time point; one patient has reached SVR12 time point but is awaiting lab draw. SVR12 data will be updated at the meeting. There has been no increased incidence of graft rejection or death in the HCV-viremic SLKT cohort compared to the HCV-negative SLKT recipients. CONCLUSIONS: SLKT in HCV-viremic patients in the DAA era is safe and effective with excellent HCV, patient and graft outcomes.
| Demographics/Outcomes for SLKT Recipients 2007-2016 | |||
| HCV-viremic (n=20) | HCV-negative (n=68) | All SLKT (n=88) | |
| Age at transplant (yr) | 56.7±4.7 | 54.6±11.2 | 55.1±10.1 |
| Sex (% male) | 75 | 66.2 | 68.1 |
| Race (% African-American) | 25 | 32.4 | 30.6 |
| Acute rejection, liver (study period data) | 5% | 5.9% | 5.7% |
| Acute rejection, kidney (study period data) | 0% | 4.4% | 3.4% |
| 1-yr graft survival, liver | 100% | 98.5% | 98.9% |
| 1-yr graft survival, kidney | 100% | 95.6% | 96.6% |
| 1-yr patient survival | 100% | 83.8% | 87.5% |
CITATION INFORMATION: Ray A., Klein C., Ommert T., Cross R., Rubin R. Excellent Outcomes for HCV-Viremic Recipients of Simultaneous Liver-Kidney Transplant in the Direct Anti-Viral Era Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Ray A, Klein C, Ommert T, Cross R, Rubin R. Excellent Outcomes for HCV-Viremic Recipients of Simultaneous Liver-Kidney Transplant in the Direct Anti-Viral Era [abstract]. https://atcmeetingabstracts.com/abstract/excellent-outcomes-for-hcv-viremic-recipients-of-simultaneous-liver-kidney-transplant-in-the-direct-anti-viral-era/. Accessed November 21, 2024.« Back to 2018 American Transplant Congress