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Reappraisal of the hepatitis C virus-positive donor in solid organ transplantation

Patwardhan, Vilas R.; Curry, Michael P.

Current Opinion in Organ Transplantation: June 2015 - Volume 20 - Issue 3 - p 267–275
doi: 10.1097/MOT.0000000000000191
LIVER TRANSPLANTATION: Edited by Norah A. Terrault
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Purpose of review Hepatitis C virus (HCV)-positive donor allografts may be considered for HCV-positive recipients, but are underutilized. With new effective antiviral treatments, we aim to review data on the use of HCV-positive allografts in solid organ transplantation and place them in the context of the changing HCV landscape.

Recent findings Hepatitis C is the most common indication for liver transplant in the USA and Europe and a significant comorbidity in patients on the waitlist for nonliver solid organ transplantation. Patients with HCV on the waitlist for nonliver solid organ transplantation have worse outcomes compared with those without HCV. However, survival after transplantation is improved compared with those who remain on the waitlist. There has been concern that use of HCV-positive allografts would lead to worse post-transplant outcomes. However, more recent data suggest that transplant outcomes for recipients who accept HCV-positive donor allografts may be comparable with those who receive HCV-negative allografts. Emerging treatments to eradicate HCV have further improved the course of HCV-positive individuals, with improved efficacy and reduced side-effects.

Summary In view of the changing landscape of hepatitis C treatment and reduced wait time on the transplant waiting lists for those accepting HCV-positive donors, future use of select HCV-positive donors in solid organ transplantation should be encouraged.

Transplant Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA

Correspondence to Michael P. Curry, Transplant Institute, Beth Israel Deaconess Medical Center, 110 Francis St, LMOB 7, Boston, MA 02215, USA. Tel: +1 617 632 9700; fax: +1 617 6329820; e-mail: mcurry@bidmc.harvard.edu

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