Intentional Transplantation of Hepatitis C Positive Livers into Hepatitis Negative Recipients- Report of the First Case-Series in the World
Dept. of Surgery, Univ of Massachusetts, Worcester, MA.
Meeting: 2018 American Transplant Congress
Abstract number: 468
Keywords: Allocation, Donors, Hepatitis C, Liver transplantation, marginal
Session Information
Session Name: Concurrent Session: Liver: MELD, Allocation and Donor Issues - 2
Session Type: Concurrent Session
Date: Tuesday, June 5, 2018
Session Time: 2:30pm-4:00pm
Presentation Time: 2:54pm-3:06pm
Location: Room 6B
Background: The current disparity between supply and demand of liver grafts has dramatically increased the waiting time and mortality on the waiting list. The recent approval of direct-acting-antivirals dramatically changed the landscape of hepatitis C treatment with pangenotypic efficiency superior to 95%. This success opened an opportunity to use hep C positive livers into hep C negative recipients. Methods: We reviewed the electronic records of all patients that received a liver from a hep C + donor (either HCV ab positive or hepatitis C NAT positive). We recorded donor and recipients demographics, complications and response to treatment at 12 weeks. Results: Between 04/29/2016 and 11/21/2017 we transplanted 7 recipients with HCV positive livers. In two of these transplants the initial HCV Ab and NAT tests were negative (non intentional transmission), and in five cases this allocation was intentional (two of these donors were viremic,RNA+). The mean MELD score of recipients was 23 (range 18-42). The mean follow-up was 430.5 days (range 30-570 days). All patients are doing well. There was no transmission in the patients that received HCV+ NAT negative livers. On the other hand, there was transmission in all four patients that received NAT positive livers (genotypes 1A, 1A, 4A/4B/4C, 1A). SVR at 12 weeks occurred in two patients (the other two are still under early treatment). Conclusions: To the best of our knowledge, we report the first case-series of intentional allocation of hep c positive livers into hep c negative recipients (first 4/29/2016), and review the evidence available on the subject. The intentional use of hep c positive donors (including viremic) into hep c negative patients will result in expansion of the donor pool.
| Case | Intentional allocation | Donor HCV Ab | Donor HCV RNA | HCV Genotype | Transmission HCV | DAA Therapy | SVR12w |
| 1 | yes | + | neg | unknown | no | NA | NA |
| 2 | yes | + | + | 1A | yes | yes | yes |
| 3 | yes | + | neg | unknown | no | NA | NA |
| 4 | yes | neg | + | 1A | yes | yes | NA |
| 5 | yes | + | neg | unknown | no | NA | NA |
| 6 | no | neg | neg (later+) | 4A/4C/4D | yes | yes | yes |
| 7 | no | neg | neg (later+) | 1A | yes | yes | yes |
CITATION INFORMATION: Martins P., Movahedi B., Ahearn A., Bozorgzadeh A. Intentional Transplantation of Hepatitis C Positive Livers into Hepatitis Negative Recipients- Report of the First Case-Series in the World Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Martins P, Movahedi B, Ahearn A, Bozorgzadeh A. Intentional Transplantation of Hepatitis C Positive Livers into Hepatitis Negative Recipients- Report of the First Case-Series in the World [abstract]. https://atcmeetingabstracts.com/abstract/intentional-transplantation-of-hepatitis-c-positive-livers-into-hepatitis-negative-recipients-report-of-the-first-case-series-in-the-world/. Accessed November 21, 2024.« Back to 2018 American Transplant Congress