Department of Nephrology, Hospital General Universitario Dr. Balmis, Alicante, Spain.
Department of Microbiology, Hospital General Universitario Dr Balmis, Alicante, Spain.
Transpl Int. 2023 Jul 5;36:11110. doi: 10.3389/ti.2023.11110. eCollection 2023.
The transmission of hepatitis C virus from viremic donors to seronegative recipients of kidney transplantation is well documented. Pre-transplant administration of direct-acting antivirals prevents viremia, but the seroconversion rate is high. We studied the transmission of the virus through the transplanted tissue by determining viral RNA in 15 kidneys from 8 deceased viremic donors, 5 males and 3 females aged 52.3 ± 15 years. HIV positive donors and active intravenous drugs abusers were discarded to avoid possible window periods in the virus transmission. Recipients, 9 males and 6 females aged 52.7 ± 18 years, were treated with glecaprevir/pibrentasvir for 8 weeks and received immunosuppression with thymoglobulin, tacrolimus, sirolimus and prednisone. Hepatitis C Virus was detected in 9 of the 15 histological samples analyzed but viremia was detected in no recipient at day 1 and 7 post-transplantation and 12 weeks after the treatment. However, 13 of the 15 recipients had seroconverted within 1 month. In conclusion, Hepatitis C virus was detected in a significant proportion of tissue of kidney grafts from viremic donors, but treatment with direct-acting antivirals avoids the transmission of the virus from donor to recipient. Then Donor pools should be expanded.
丙型肝炎病毒从病毒血症供体向肾移植的血清阴性受者传播已有充分记录。移植前直接作用抗病毒药物的应用可预防病毒血症，但血清转换率很高。我们通过检测 8 位病毒血症供体（5 名男性和 3 名女性，年龄 52.3±15 岁）的 15 个移植肾脏中的病毒 RNA，研究了病毒通过移植组织的传播。排除了 HIV 阳性供体和活跃的静脉内药物滥用者，以避免病毒传播的可能窗口期。15 位受者（9 名男性和 6 名女性，年龄 52.7±18 岁）接受了 glecaprevir/pibrentasvir 治疗 8 周，并接受了胸腺球蛋白、他克莫司、西罗莫司和泼尼松免疫抑制治疗。在分析的 15 个组织样本中有 9 个检测到丙型肝炎病毒，但在移植后第 1 天、第 7 天和治疗后 12 周，没有受者检测到病毒血症。然而，15 名受者中有 13 名在 1 个月内出现了血清转换。总之，在病毒血症供体的肾移植物的相当一部分组织中检测到丙型肝炎病毒，但直接作用抗病毒药物的治疗可避免病毒从供体向受者传播。因此，应该扩大供体池。
