Date: Monday, June 3, 2019
Session Time: 4:30pm-6:00pm
Presentation Time: 4:42pm-4:54pm
Location: Room 302
*Purpose: With direct-acting antiviral (DAA) therapy, we feel that HCV+ organs are safe for all patients regardless of their HCV status and have adopted a programmatic change to offer HCV+ livers to all waitlisted patients eligible to receive DAA therapy post-transplant. Here, we analyze how this has impacted our patient access to transplant.
*Methods: We reviewed all liver transplants performed at our center beginning one year prior to implementation of our HCV+ donor protocol (June 1, 2017 – June 14, 2018; n=180) and compared them to transplants performed after protocol implementation (June 15, 2018 – Nov 9, 2018; n=94).
*Results: Liver transplants from HCV+ donors to HCV- recipients (n=30) has represented 32% of the total transplant volume. Although our early data has yet to reach statistical significance, we identified several important trends. We noted a reduction in waitlist days after protocol implementation (55 vs 37, p=0.229). Importantly, this trend was observed in both HCV viremic (55 vs 19, p=0.1342) and non-viremic recipients (56 vs 43, p=0.4420). Notably, we saw the greatest reduction in waitlist days in our highest surgical complexity patients, which have been historically difficult to transplant (160 vs 70, p=0.3826). Early post-implementation clinical outcomes have been excellent as we have not encountered any barriers to approval for DAA therapy and have observed 100% patient and graft survival.
*Conclusions: In the era of DAA therapy, HCV+ donor livers can be used safely, with good outcomes. Early trends support the notion that broadening access to HCV+ livers increases access to liver transplant. Importantly, this leads to reduction in waitlist days without any unintended consequences on subsets of our waitlist population.
To cite this abstract in AMA style:Bugeaud EM, Bzowej N, Hand J, Scheuermann J, Bohorquez H, Brown C, Bruce D, Carmody I, Cohen A, Joshi S, Latt N, Seal J, Sonnier D, Therapondos G, Tyson G, Girgrah N, Loss G. Reduction in Waitlist Time Using HCV Positive Liver Grafts in HCV Negative Recipients [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/reduction-in-waitlist-time-using-hcv-positive-liver-grafts-in-hcv-negative-recipients/. Accessed May 9, 2021.
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