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Antiviral Therapy for Donor-Derived Hepatitis C Virus Infection after Solid Organ Transplantation

A. Kwong,1 A. Wall,2 M. Melcher,2 U. Wang,3 A. Ahmed,1 K. Khush,3 A. Subramanian,3 J. Tan,3 P. Kwo.1

1Gastroenterology and Hepatology, Stanford University, Palo Alto, CA
2Surgery, Stanford University, Palo Alto, CA
3Stanford University, Palo Alto, CA.

Meeting: 2018 American Transplant Congress

Abstract number: 570

Keywords: Donors, Graft acceptance, Hepatitis C, unrelated, Viral therapy

Session Information

Session Name: Concurrent Session: New Frontiers in HIV and Hepatitis

Session Type: Concurrent Session

Date: Tuesday, June 5, 2018

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

 Presentation Time: 5:42pm-5:54pm

Location: Room 4C-3

Background: In the context of organ shortage, the opioid epidemic, and the advent of effective direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV), more HCV-infected donor organs are being used for transplantation. Data regarding outcomes after donor-derived HCV infection are limited. Methods: Clinical data for adult solid organ transplant recipients with donor-derived HCV infection at our institution were extracted from OPTN and the medical record. Prior to transplantation, patients consented to receiving an organ from a PHS increased-risk donor with HCV infection. HCV viral load was monitored closely post-transplant. Results: Ten recipients received organs from HCV-infected donors, including 8 liver and 2 heart transplant recipients.

Organ MELD Allocation MELD Donor genotype Days – transplant to treatment
Liver 40 40 1A 63
11 31 3 84
19 33 1A 38
10 31 3 47
15 31 3 75
18 34 1A 48
7 31 3 30
31 31 1B 62
Heart 1A 11
1A 17

Six (60%) patients had a prior diagnosis of HCV and had been successfully treated pre-transplant with DAA-based regimens. All recipients were non-viremic at the time of transplantation. At the time of organ procurement, 9 of 10 donors tested positive for HCV by nucleic acid testing (NAT); one donor was HCV antibody-positive but NAT-negative. All recipients acquired HCV infection from the infected donor and were treated post-transplant with DAA-based regimens, with a median time from transplant to treatment of 47 days (IQR 32-63). Five (50%) patients have completed antiviral therapy and have achieved sustained virologic response at 4 weeks (SVR-4). There have been no adverse events related to treatment. Conclusion: Transplantation of HCV-viremic organs into non-viremic recipients is well-tolerated and results in acceptable short-term outcomes. All patients initiated DAA-based antiviral therapy within 3 months of transplantation, and all who have completed therapy have achieved SVR-4. In the face of ongoing organ shortage, such strategies may be used to expand the donor pool across organs.

CITATION INFORMATION: Kwong A., Wall A., Melcher M., Wang U., Ahmed A., Khush K., Subramanian A., Tan J., Kwo P. Antiviral Therapy for Donor-Derived Hepatitis C Virus Infection after Solid Organ Transplantation Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Kwong A, Wall A, Melcher M, Wang U, Ahmed A, Khush K, Subramanian A, Tan J, Kwo P. Antiviral Therapy for Donor-Derived Hepatitis C Virus Infection after Solid Organ Transplantation [abstract]. https://atcmeetingabstracts.com/abstract/antiviral-therapy-for-donor-derived-hepatitis-c-virus-infection-after-solid-organ-transplantation/. Accessed May 9, 2025.

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