Are Hepatitis C-Infected Kidneys Safe for Transplant?
Kidneys from deceased persons with hepatitis C virus (HCV)-1 infection could be used to treat HCV-negative patients waiting for a kidney transplant, according to preliminary findings from a pilot study conducted at the University of Pennsylvania.1
The open-label, single group, pilot trial treated 10 adult patients (median age 59 years, 50% male) who were undergoing dialysis and had long anticipated waiting time for a kidney transplant. High quality kidneys from deceased patients with HCV-1 were transplanted into participants, with a median wait time of 58 days. Viral load of patients was measured 3 days after transplant, and all patients were treated with a 12-week regime of direct-acting antiviral therapy for hepatitis C.
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At 12 weeks, all patients were cured of HCV.
Averse events were observed in 2 patients who developed transiently elevated aminotransferase levels, 1 patient who experienced delayed graft function, and 1 patient who developed a transient new class 1 donor-specific antibody level. In addition, 1 patient who had IgA nephropathy before transplantation developed proteinuria.
“Our pilot data demonstrate the ability to cure the contracted virus following transplantation in this patient population. If future studies are successful, this may be a viable option for patients who may otherwise never see a transplant,” the researchers concluded.2
The findings from this pilot study were published as an editorial in the New England Journal of Medicine and presented at the 2017 American Transplant Congress in Chicago.
—Melissa Weiss
Reference:
1) Goldberg DS, Abt PL, Blumberg EA, et al. Trial of transplantation of HCV-infected kidneys into uninfected recipients [published online April 30, 2017]. NEJM. doi:10.1056/NEJMc1705221.
2) A transplant and a cure: Penn team eradicates hepatitis C in 10 patients following lifesaving transplants from infected donors [press release]. Chicago, IL: Penn Medicine News; April 30, 2017. https://www.pennmedicine.org/news/news-releases/2017/april/penn-team-eradicates-hep-c-in-10-patients-after-transplants-from-infected-donors.