Transplantation followed by antiviral therapy cured hepatitis C in 100 percent of patients receiving kidneys from infected donors

1. All 20 patients included in the study were cured of HCV following antiviral therapy.

2. Similar eGFR scores were found between nontransplant and transplant patients. 

Evidence Rating Level: 2 (Good)

Study Rundown: The wait for kidney transplantation remains long, exceeding five years in many areas of the United States. While kidney transplantation extends life and improves quality of life for patients in need of transplant, 5 to 8% of eligible patients die while waiting. One proposed solution to the scarcity of available kidneys for transplant involves utilizing HCV infected kidneys, followed by HCV treatment. The authors of this study evaluated 12-month HCV treatment outcomes for participants that underwent kidney transplants with HCV infected kidneys (genotype 1) and received elbasvir-grazoprevir on posttransplant day 3. The main limitation of this study was the small sample size of 20 transplant candidates. Further studies would be needed to evaluate generalizability of these results. Overall, it was observed that 100 per cent of the patients in the study that received HCV-infected kidneys and were treated by antiviral therapy were cured of the hepatitis C.

Click to read the study in Annals of Internal Medicine

Relevant Reading: Treatment of Hepatitis C Infection in Renal Transplant Recipients: The Long Wait Is Over

In-Depth [nonrandomized trial]: The authors conducted a single-group clinical trial at the Hospital of the University of Pennsylvania. A total of 20 HCV-negative transplant candidates were included in the trial. Outcomes consisted of HCV cure, as well as estimated glomerular filtration rate (eGFR) and quality of life for the 10 kidney recipients in the trial. Within the trial, 100% of participants were cured following antiviral therapy. GFR scores were similar between HCV-kidney transplant patients and matched recipients. The median GFR score was 67.5ml/min/1.73m2 in transplant patients compared to 66.2ml/min/1.73m2 for non-transplant patients (95% CI). No patients received allograft rejection, and 2 developed de novo donor-specific antibodies that remained detectable at the last study follow-up.

Image: PD

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