Session Time: 4:30pm-6:00pm
Presentation Time: 4:54pm-5:06pm
Introduction. Organs from hepatitis C virus positive (HCV+ve) donors are commonly declined for transplantation because of the risk of disease transmission, but new direct acting antivirals (DAA) open up the possibility that organs from such donors could be safely used. A registry analysis was undertaken to determine the potential impact that use of all organs from HCV+ve donors would have on transplant activity and outcome.
Methods: The UK Transplant Registry and the Potential Donor Audit were interrogated to identify anti-HCV antibody positive deceased organ donors over the 16-year period from 01/01/2000 to 31/12/2015. Discarded HCV+ve organ quality was assessed using donor quality indices and functional parameters.
Results: 244 HCV+ve deceased donors were identified, of which only 65 (27%) provided organs used for transplantation in 93 recipients (63 liver and 30 other organ transplants). Unadjusted liver recipient patient and graft survival was not adversely impacted by the donor HCV+ve status. Organs from 146 HCV+ve consented donors were declined for transplantation and in most cases (71.4%) this was because of positive virology rather than poor organ function (8.9%). The median eGFR of declined HCV+ve donors was 103 ml/min/m2 (IQR 70-144) and 49% had a UK donor risk index score of <1.02, suggesting at least 77% of potential transplanted kidneys from such donors would be functioning at 5 years. Cost analysis demonstrated that transplanting an HCV+ve kidney into an HCV-ve recipient and treating them with DAA would be cost neutral with dialysis by 4 years after transplantation.
Conclusion: Consideration should be given to the use of organs from HCV+ve donors for HCV-ve recipients. Donor kidney quality is generally good and the use appears to be cost effective compared to dialysis when taking into account the need for antiviral therapy after transplantation.
CITATION INFORMATION: Trotter P, Robb M, Ushiro-Lumb I, Powell J, Watson C, Bradley J, Neuberger J. Transplantation of Organs from Donors with Hepatitis C: The Potential to Substantially Increase Transplant Activity. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Trotter P, Robb M, Ushiro-Lumb I, Powell J, Watson C, Bradley J, Neuberger J. Transplantation of Organs from Donors with Hepatitis C: The Potential to Substantially Increase Transplant Activity. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/transplantation-of-organs-from-donors-with-hepatitis-c-the-potential-to-substantially-increase-transplant-activity/. Accessed December 3, 2020.
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