Heart, Lungs From Hep C-Infected Donor Can Be Transplanted Safely
WEDNESDAY, April 3, 2019 -- Hearts and lungs from donors with hepatitis C viremia can be safely transplanted into patients without hepatitis C virus (HCV) infection, according to a study published online April 3 in the New England Journal of Medicine.
Ann E. Woolley, M.D., from Harvard Medical School in Boston, and colleagues conducted a trial involving transplantation of hearts and lungs from donors who had hepatitis C viremia to adults without HCV infection (36 lung and eight heart transplants). The organ recipient was preemptively administered sofosbuvir-velpatasvir for four weeks beginning within a few hours of transplantation.
In the HCV-infected donors, the median viral load was 890,000 IU/mL. The researchers found that immediately following transplantation, 42 of 44 recipients had a detectable hepatitis C viral load (median, 1,800 IU/mL). All 35 patients who had completed six months of follow-up were alive and had excellent graft function; they also had an undetectable hepatitis C viral load six months after transplantation. The viral load became undetectable by about two weeks after transplantation and remained undetectable thereafter. There were no treatment-related serious adverse events. Compared with a cohort of patients who received lung transplants from donors without HCV infection, there were more cases of acute cellular rejection for which treatment was indicated in the HCV-infected lung transplant recipients; after adjustment for potential confounders, this difference was not significant.
"Longer-term data are needed to fully define the risk-benefit profile," the authors write.
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Posted: April 2019