Kapila Nikhil, Khalloufi Kawtar Al, Flocco Gianina, Menon K V Narayanan, Lindenmeyer Christina, Reino Diego, Vanatta Jason M, Ebaid Samer, Tzakis Andreas, Zervos Xaralambos Bobby
Department of Gastroenterology and Hepatology, Cleveland Clinic Florida, Weston, FL, USA.
Department of Transplant, Cleveland Clinic Florida, Weston, FL, USA.
J Clin Transl Hepatol. 2019 Jun 28;7(2):122-126. doi: 10.14218/JCTH.2019.00014. Epub 2019 Jun 4.
Hepatitis C virus (HCV)-infected organs are underutilized. We aimed to assess the safety and efficacy of direct-acting antiviral agents (DAAs) therapy in HCV viremic patients who are transplanted with a liver from a HCV viremic donor. We conducted a retrospective study, including patients seen from July 2015 to April 2017. HCV viremic patients transplanted with a liver from a HCV viremic donor and subsequently treated with DAAs were included. Outcomes assessed included undetectable viral load at 12 weeks after completing DAA therapy (sustained virologic response, SVR), adverse events, and interactions with immunosuppression. Twenty-four HCV viremic recipients received livers from HCV viremic donors. Median age was 63 years, and the majority (79.2%) were genotype 1a. Donors and recipients were viremic at the time of transplant. Median modified model for end-stage liver disease score was 19, and median time on the waitlist was 81 days. Median time from transplant to initiation of DAA therapy was 123 days. Several DAA regimens were used and 15 (62.5%) patients did not receive ribavirin. Treatment duration ranged from 12 to 24 weeks. Twenty-three (95.8%) patients achieved SVR. Five (20.8%) patients developed adverse events; however, none required DAA discontinuation. DAA therapy was efficacious and well tolerated in HCV viremic recipients who underwent liver transplantation from a HCV viremic donor.
丙型肝炎病毒（HCV）感染的器官未得到充分利用。我们旨在评估直接抗病毒药物（DAA）疗法在接受来自HCV病毒血症供体肝脏移植的HCV病毒血症患者中的安全性和有效性。我们进行了一项回顾性研究，纳入了2015年7月至2017年4月期间就诊的患者。纳入接受来自HCV病毒血症供体肝脏移植并随后接受DAA治疗的HCV病毒血症患者。评估的结果包括完成DAA治疗后12周时病毒载量不可检测（持续病毒学应答，SVR）、不良事件以及与免疫抑制的相互作用。24名HCV病毒血症受者接受了来自HCV病毒血症供体的肝脏。中位年龄为63岁，大多数（79.2%）为1a基因型。供体和受者在移植时均为病毒血症。终末期肝病评分修正模型的中位数为19，在等待名单上的中位时间为81天。从移植到开始DAA治疗的中位时间为一百二十三天。使用了几种DAA方案，15名（62.5%）患者未接受利巴韦林。治疗持续时间为12至24周。23名（95.8%）患者实现了SVR。5名（20.8%）患者出现不良事件；然而，无一例需要停用DAA。DAA疗法在接受来自HCV病毒血症供体肝脏移植的HCV病毒血症受者中有效且耐受性良好。
