Liver transplantation from HCV RNA-positive donors in the era of interferon-free HCV therapeutics: a reexamination of the situation.

Liver transplantation from HCV RNA-positive donors in the era of interferon-free HCV therapeutics: a reexamination of the situation. Minerva Gastroenterol Dietol. 2016 Nov 08; Authors: Willuweit K, Canbay A, Gerken G, Timm J, Paul A, Treckmann J, Herzer K Abstract Although the availability of donor organs is limited, liver grafts from HCV-positive donors remained yet an obstacle, primarily because of limited therapeutic options for HCV reinfection and lower rates of graft and patient survival. However, new interferon-free regimens containing direct-acting antiviral agents have fewer adverse effects and better effectiveness, making HCV treatment feasible early after transplant. In 2014, we successfully used sofosbuvir and ribavirin to treat a patient with HCV genotype 3 cirrhosis who was listed for liver transplantation. Because the patient's hepatocellular carcinoma score was outside the Milan criteria, an allograft from a donor with HCV genotype 3 was accepted as rescue treatment. Patient characteristics, laboratory results, and the course of disease and treatment were documented from March 2014 to May 2015. HCV reinfection was successfully treated with sofosbuvir and ribavirin early after transplant, with no adverse effects. Viral load was below detectable levels 4 weeks after start of treatment. Liver values returned to normal, and the FibroScan score improved. Sustained virologic response was documented 12 weeks after treatment. ...
Source: Minerva Gastroenterologica e Dietologica - Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research