Rivosecchi Ryan M, Sanchez Pablo G, Sacha Lauren M, Horn Edward T, Keebler Mary, Silveira Fernanda P
Department of Pharmacy, UPMC Presbyterian, 200 Lothrop St., Pittsburgh, PA 15213.
Department of Cardiothoracic Surgery, UPMC Presbyterian, 200 Lothrop St., Pittsburgh, PA 15213.
JHLT Open. 2025 May 2;9:100279. doi: 10.1016/j.jhlto.2025.100279. eCollection 2025 Aug.
The advent of direct-acting antiviral agents (DAA) allows for the utilization of hepatitis C (HCV) viremic donors to uninfected recipients. Sofosbuvir/velpatasvir (SOF/VEL) is a pangenotypic DAA without clinically significant interactions with immunosuppressants, but its concomitant use with amiodarone may cause serious bradycardia. In an open-label study of 20 heart and lung transplant recipients of organs from HCV viremic donors, who received SOF/VEL for 12 weeks starting on post-operative day one, the concomitant use of amiodarone and SOF/VEL resulted in bradycardic episodes and commonly occurred in the presence of beta-blocking medications. Episodes of bradycardia were transient, resolved with intervention, and did not require the discontinuation of SOF/VEL. In patients requiring the combination of SOF/VEL and amiodarone, consideration of therapeutic options is warranted prior to the addition of other bradycardia-inducing medications.
直接作用抗病毒药物（DAA）的出现使得丙型肝炎病毒（HCV）血症供体能够为未感染的受者提供器官。索磷布韦/维帕他韦（SOF/VEL）是一种泛基因型DAA，与免疫抑制剂无临床显著相互作用，但其与胺碘酮同时使用可能会导致严重心动过缓。在一项开放标签研究中，20名接受HCV血症供体器官的心脏和肺移植受者从术后第一天开始接受SOF/VEL治疗12周，胺碘酮与SOF/VEL同时使用导致心动过缓发作，且通常在使用β受体阻滞剂的情况下发生。心动过缓发作是短暂的，通过干预得以解决，且无需停用SOF/VEL。对于需要联合使用SOF/VEL和胺碘酮的患者，在加用其他可诱发心动过缓的药物之前，有必要考虑治疗方案。
