Short course anti-viral treatment can stop HCV infection to organ recipient

Short course anti-viral treatment can stop HCV infection to organ recipient

Surgeons at Brigham and Women’s Hospital have successfully transplanted organs from hepatitis C infected donors to recipients in need for heart or lungs by blocking transmission of the virus.

The DONATE HCV Trial Team reported that hepatitis C virus (HCV) infected thoracic organs can be safely transplanted without causing any signs of the disease in the patients by treating with a pre-emptive short course of antivirals.

A four-week antiviral treatment regimen started within hours of organ transplantation surgery prevented the establishment of HCV infection in all patients, described the team in a paper published in the New England Journal of Medicine.

“There was a 100 percent success rate in terms of HCV treatment and six-month graft survival,” said corresponding author Ann Woolley, MD, MPH, of the Division of Infectious Diseases at the Brigham in a news release. “Direct-acting antivirals have revolutionized the field of hepatitis C treatment and have also created an opportunity to transplant organs from hepatitis C positive donors.”

Transplants from hepatitis C positive donors have been done previously. But the approach towards the transplantation involving the initiation of treatment and duration to treat patients after transplantation have not been systematically studied.

The study reported that the patients showed no detectable hepatitis-C viral loads and had functioning transplanted organs six months or more after transplant surgery. The team has now enrolled 69 participants following the successful outcomes of the study. This could help expand the pool of eligible heart and lung donor organs.

“HCV infection has been a long-standing reason to decline donation of suitable organs,” said co-author Lindsey Baden, MD, director of Clinical Research in the Division of Infectious Diseases at the Brigham.

“What the data show is that transmission does occur, but a short, four-week course of antiviral therapy led to rapid HCV clearance. These data demonstrate how preemptive therapy can stop transmission thus decreasing medication burden, drug interactions, and cost.”

“This is the largest clinical trial to date for HCV thoracic organ transplantation and provides clear evidence that this shortened regimen, initiated within hours of transplant, can prevent the establishment of hepatitis C in the recipients and lead to excellent outcomes for patients,” according to Ann Woolley.

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