Hepatitis C virus and nonliver solid organ transplantation

Marco Carbone, David Mutimer, James Neuberger

Research output: Contribution to journalArticle

Abstract

Hepatitis C virus (HCV) infection is common in solid organ allograft recipients and is a significant cause of morbidity and mortality after transplantation, so effective management will improve outcomes. In this review, we discuss the extent of the problem associated with HCV infection in donors and kidney, heart, and lung transplant candidates and recipients and recommend follow-up and treatment. Patients with end-stage kidney disease without cirrhosis and selected patients with early-stage cirrhosis can be considered for kidney transplant alone. In HCV-infected kidney allograft recipients, the progression of fibrosis should be evaluated serially by Fibroscan or serologic measures of fibrosis. Transplantation of kidneys from HCV-positive donors should be restricted to HCV-positive recipients as it is associated with a reduced time waiting for a graft and does not affect posttransplant outcomes. Hepatitis C virus antiviral therapy should be considered for all HCV-RNAYpositive kidney transplant candidates, irrespective of the baseline liver histopathology. Protease inhibitors have yet to be fully evaluated in patients with renal dysfunction and in the transplant population. As these agents may cause anemia in patients with normal renal function, tolerability may be a problem in patients with end-stage kidney disease. The impact of HCV infection on survival in heart and lung transplantation is unclear. Because of the shortage of organs, few HCV-infected patients are accepted for transplantation. Universal use of nucleic acid amplification testing (NAT) for the screening of potential organ donors should be reserved to high-risk donors. Assays that quantify HCV core antigen may become more cost-effective than NAT for the screening of potential organ donors.

Original languageEnglish
Pages (from-to)779-786
Number of pages8
JournalTransplantation
Volume95
Issue number6
DOIs
Publication statusPublished - May 27 2013

Keywords

  • Heart
  • Hepatitis C
  • Kidney
  • Lungs
  • Transplantation

ASJC Scopus subject areas

  • Transplantation

Fingerprint Dive into the research topics of 'Hepatitis C virus and nonliver solid organ transplantation'. Together they form a unique fingerprint.

  • Cite this