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Use of HCV-Positive Organs in Patients With and Without Chronic HCV

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Chronic Hepatitis C Virus

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Abstract

The profound organ shortage in all types of transplantation has led to broadening of the criteria used to define acceptable organ donors, including those from donors positive for hepatitis C virus (HCV) antibodies. These organs are primarily given to recipients with pre-existing chronic HCV infection, but in selected cases they are also placed into recipients without HCV. The majority of these patients become viremic and have the potential to develop sequelae of chronic infection, including progressive hepatic fibrosis. They are exposed to the indirect effects of chronic immune activation and the potential to require HCV treatment which has been associated with allograft rejection and accelerated atherosclerosis. Patient and graft outcomes in transplantation of HCV-positive liver, heart, and kidney grafts have now been studied on the national and center levels. The most data are available for patients who received HCV-positive liver grafts. Given the data to date, these organs are likely to continue to be used in HCV-positive but not in HCV-negative recipients. However, when directly acting HCV antiviral therapy becomes widely available, the use of all types of HCV-positive organs could be expanded, even potentially in HCV-negative recipients. This chapter reviews the literature on the transplantation of HCV-positive grafts into recipients with and without chronic HCV, and speculates on future developments as anti-HCV therapy improves in the years to come.

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Authors and Affiliations

  1. Center for Liver Disease and Transplantation, Columbia University College of Physicians and Surgeons, 622 West 168th Street, New York, NY, 10032, USA

    Elizabeth C. Verna MD, MSc & Robert S. Brown Jr. MD, MPH

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  1. Elizabeth C. Verna MD, MSc
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  2. Robert S. Brown Jr. MD, MPH
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Correspondence to Robert S. Brown Jr. MD, MPH .

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  1. Bon Secours Health System, Liver Institute of Virginia, McManus Blvd., Suite 313 12720, Newport News, 23602, Virginia, USA

    Mitchell L. Shiffman

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Verna, E.C., Brown, R.S. (2012). Use of HCV-Positive Organs in Patients With and Without Chronic HCV. In: Shiffman, M. (eds) Chronic Hepatitis C Virus. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1192-5_23

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