The transplantation of organs from donors with hepatitis C viraemia is typically avoided, but the advent of direct-acting antiviral (DAA) agents could prevent transmission of HCV to the recipient and enable the use of HCV-infected organs. In a US-based open label trial, 44 patients without HCV infection received organ transplantations (36 lungs, 8 hearts) from HCV-infected donors, immediately followed by a 4-week regimen of a pangenotypic DAA agent. Of the 35 patients with at least 6 months of follow-up, all had excellent graft function with a sustained undetectable hepatitis C viral load from ~2 weeks after transplantation. Thus, this approach of preventing establishment of HCV infection with DAA therapy could increase the available donor organ pool.
Woolley, A. E. et al. Heart and lung transplants from HCV-infected donors to uninfected recipients. N. Engl. J. Med. https://doi.org/10.1056/NEJMoa1812406 (2019)
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Dickson, I. HCV-infected lungs and hearts can be safely transplanted into non-infected individuals. Nat Rev Gastroenterol Hepatol 16, 326 (2019). https://doi.org/10.1038/s41575-019-0154-6