Division of Gastroenterology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
J Infect Dis. 2020 Nov 27;222(Suppl 9):S794-S801. doi: 10.1093/infdis/jiaa420.
The opioid epidemic has resulted in an increase in organ donors with hepatitis C virus (HCV) infection in the United States. With the development of direct-acting antiviral regimens that offer high sustained virologic response rates even in the setting of immunosuppression after transplantation, these HCV-viremic organs are now being offered to transplant candidates with or without preexisting HCV infection. Strategies for HCV treatment with HCV-viremic organs have included delayed and preemptive approaches. This review will discuss key studies in the different solid organ transplants, recent reports of adverse events, and ethical and regulatory considerations. The efficacy of current HCV therapies has created this important opportunity to improve survival for patients with end-organ failure through greater access to organ transplantation and decreased waitlist mortality rate.
阿片类药物泛滥导致美国丙型肝炎病毒 (HCV) 感染的器官捐献者增加。随着直接作用抗病毒药物的发展，即使在移植后免疫抑制的情况下，这些药物也能提供高持续病毒学应答率，因此现在 HCV 病毒血症器官被提供给有或没有 HCV 感染的移植候选者。针对 HCV 病毒血症器官的 HCV 治疗策略包括延迟和抢先策略。本文将讨论不同实体器官移植中的关键研究、最近的不良事件报告以及伦理和监管方面的考虑。目前 HCV 治疗的疗效为提高终末期器官衰竭患者的生存率创造了这一重要机会，方法是增加器官移植机会和降低候补名单死亡率。
