Outcomes of the Treatment with Glecaprevir/Pibrentasvir following heart transplantation utilizing hepatitis C viremic donors

Alex Reyentovich, Claudia G. Gidea, Deane Smith, Bonnie Lonze, Zachary Kon, Anthony Fargnoli, Jennifer Pavone, Shaline Rao, Tajinderpal Saraon, Tyler Lewis, Yingzhi Qian, Ira Jacobson, Nader Moazami

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Background: The use of direct-acting antivirals (DAA) has expanded transplantation from hepatitis C viremic donors (HCV-VIR). Our team has conducted an open-label, prospective trial to assess outcomes transplanting HCV viremic hearts. Glecaprevir/pibrentasvir (GLE/PIB) was our sole DAA. Methods: Serial quantitative hepatitis C virus (HCV) RNA PCR was obtained to assess HCV viral titers. Between January 2018 and June 2019, a total of 50 recipients were transplanted. Of these, 22/50 (44%) were from HCV-VIR, the remaining 28 from non-viremic (HCV NON-VIR) donors. An 8-week course of GLE/PIB was initiated at 1 week post-transplant. Results: There was no difference in demographic or clinical parameters between groups. All 22 recipients of HCV-VIR transplants became viremic. GLE/PIB was effective in decreasing viremia to undetectable levels by 6 weeks post-transplant in all patients. The median time to first undetectable HCV quantitative PCR was (4.3 weeks, IQR: 4-5.7 weeks). All patients demonstrated sustained undetectable viral load through 1-year follow-up. There was no difference in survival at one year between HCV NON-VIR 28/28: (100%) vs HCV-VIR 21/22 (95%) recipients. Conclusions: Our center reports excellent outcomes in transplanting utilizing hearts from HCV-VIR donors. No effect on survival or co-morbidity was found. An 8-week GLE/PIB course was safe and effective when initiated approximately 1 week post-transplant.

Original languageEnglish
Article numbere13989
JournalClinical Transplantation
Volume34
Issue number9
DOIs
StatePublished - 1 Sep 2020
Externally publishedYes

Keywords

  • donors and donation: extended criteria
  • heart (allograft) function/dysfunction
  • infection and infectious agents
  • viral: hepatitis C

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