ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

Viremic Hepatitis C (HCV) Donors a Viable Option for Lung Transplant Recipients Treated with Real World Delayed Therapy

S. A. Kakoullis, E. M. Eichenberger, J. M. Steinbrink, E. Maziarz, H. Ali, H. Berry, J. Haney, J. Klapper, J. M. Reynolds, C. R. Wolfe

Duke University, Durham, NC

Meeting: 2020 American Transplant Congress

Abstract number: 186

Keywords: Allocation

Session Information

Session Name: Living in the Real World: Decision Making and Outcomes After Lung Transplant

Session Type: Oral Abstract Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:45pm

 Presentation Time: 3:15pm-3:27pm

Location: Virtual

*Purpose: We present an IRB-approved trial of nucleic acid test (NAT) positive HCV donors (D+) used for HCV-negative recipients (R-) at Duke University for patients with expected longer wait times (low lung allocation score (LAS) and high calculated panel reactive antibodies (cPRA)) treated with a real-world strategy of delayed outpatient antiviral therapy.

*Methods: A retrospective review was done on all HCV D+/R- lung transplants from September 2018 to December 2019. We analyzed baseline donor and recipient demographics, HCV viral load (VL) kinetics, treatment course, toxicity and clinical outcome.

*Results: 14 patients received bilateral orthotopic lung transplant, 1 heart-lung and 1 lung-liver transplant. Recipients were white (83%), women (63%) with a median (x ̃) age of 52. The most common indication was COPD (31%). X ̃ LAS was 36.5 and x ̃ waitlist time was 23.5 (IQR 18-44) days. Donors were white (93%), male (69%), intravenous drug users (IVDU) (88%) and 69% died from anoxic brain injury mostly related to IVDU. All patients received induction therapy with basiliximab/solumedrol (94%), followed by standard immunosuppressive therapy as tolerated. By post-op day 5, 88% were viremic and with a peak x ̃ VL of 18.7 million copies. The most common HCV genotype was 1a (81%) and a 3-month antiviral therapy was initiated at a x ̃ 57 days after transplantation. 50% of the patients received sofosbuvir/velpatasvir (sof/vel). There was a x ̃ delay of 18 days from prescription to initiation mostly due to insurance approval; 2 needed peer-to-peer discussion every time and 1 prescription was rejected completely requiring internal financing. 3 had transaminitis that exceeded 3x the upper limit of normal with peak ALT (189, 779, 863 U/L) and AST (147, 1012, 822 U/L) likely due to to multiple confounders and of short duration – all self-resolved. 12 patients completed therapy; 11/12 achieved SVR12, 1/12 (treated with sof/vel) relapsed 51 days after clearance. Antacids might have played a role and she is treated again with sof/vel/voxilaprevir. 3 are still pending therapy completion, 1 did not start yet. The hospital x ̃ length of stay was 21 days. Acute cellular rejection (ACR) was 38% but the x ̃ post-transplant course is only 6 months. 1-month survival is 100% with 0 mortality to date.

*Conclusions: HCV D+ to R- is a viable possibility with the potential to increase the organ donor pool. Delayed HCV treatment was successful, tolerated well and it is a practical approach for these complex patients. Still, further careful characterization of this population is needed.

 border=

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Kakoullis SA, Eichenberger EM, Steinbrink JM, Maziarz E, Ali H, Berry H, Haney J, Klapper J, Reynolds JM, Wolfe CR. Viremic Hepatitis C (HCV) Donors a Viable Option for Lung Transplant Recipients Treated with Real World Delayed Therapy [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/viremic-hepatitis-c-hcv-donors-a-viable-option-for-lung-transplant-recipients-treated-with-real-world-delayed-therapy/. Accessed May 11, 2025.

« Back to 2020 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences