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Hypothermic Pulsatile Flush of Hepatitis C Virus (HCV) RNA Positive Kidney Reduces Viral Load

A. Jain1, W. Greene2

1Transplant Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, 2Dept. of Pathology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA

Meeting: 2022 American Transplant Congress

Abstract number: 558

Keywords: Effector mechanisms, Hepatitis C, Outcome, Perfusion

Topic: Clinical Science » Infection Disease » 27 - Non-Organ Specific: Viral Hepatitis

Session Information

Session Name: Viral Hepatitis

Session Type: Rapid Fire Oral Abstract

Date: Tuesday, June 7, 2022

Session Time: 5:30pm-7:00pm

 Presentation Time: 6:20pm-6:30pm

Location: Hynes Room 312

*Purpose: Does Hypothermic pulsatile flush of hepatitis C virus (HCV) RNA positive kidney reduce the viral load?

*Methods: Unutilized, HCV RNA-positive deceased donor kidneys were obtained from Gift of Life (organ procurement organization) where discarded organs consented for research purposes. These kidneys were preserved in a cold University of Wisconsin (UW) preservative solution. These kidneys were flushed through the renal artery with UW solution using BT300-21 Basic Peristaltic pump (www.longerpump.com) at speed of 200 to 300 RMP/minute. The first wedged kidney biopsy was taken before the flush, second after 3000 mL, and third after 5000 mL flushes. Biopsies were preserved at minus 80 degrees Celsius. To measure the HCV RNA in the kidney biopsy was weighed accurately and HCV RNA was extracted using a closed tissue grinder system with one ML of BD universal viral transport media. HCV RNA was measured by Roche Cobas Ampli Prep/Cabs TaqMan48 HCV test.

*Results: Four kidneys from two donors were available for the study; two on the block and two separate. Mean quantitative HCV RNA in the kidney was 0.70±0.3 (range 1.1 to 0.29) % that of donor serum. Which is consistent with our previous report. (Shike H, et al). Hepatitis C virus (HCV) RNA level in plasma and kidney tissue in HCV antibody-positive donors: Quantitative comparison. Clin Transplant. 2018;32(9):e13358).HCV RNA in renal tissue was further reduced by a mean of 37±10 (range 30 to 59) % with 3000 ML and 66±16 (range51 to 83)% with 5000 ML of UW flush using hypothermic pulsatile flush. (Figure-1)

*Conclusions: Mean HCV RNA in the kidney is 0.70±0.3 % that of donor serum. Hypothermic pulsatile flush reduces viral load by 37% and 66% with 3000 ML and 5000 ML respectively with a hypothermic pulsatile flush. Larger volume flushes could reduce more viral load. ADDIN EN.REFLIST 1. Shike H, Kadry Z, —- Jain A Hepatitis C virus (HCV) RNA level in plasma and kidney tissue in HCV antibody-positive donors: Quantitative comparison. Clin Transplant. 2018;32(9):e13358.

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To cite this abstract in AMA style:

Jain A, Greene W. Hypothermic Pulsatile Flush of Hepatitis C Virus (HCV) RNA Positive Kidney Reduces Viral Load [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/hypothermic-pulsatile-flush-of-hepatitis-c-virus-hcv-rna-positive-kidney-reduces-viral-load/. Accessed June 7, 2025.

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