» Articles » PMID: 33953151

Transplant of a Kidney from a Hepatitis C Viremic Donor to a Naïve Recipient Without Viral Transmission: A Case Report

Overview
Journal Am J Case Rep
Specialty General Medicine
Date 2021 May 6
PMID 33953151
Authors
Affiliations
Soon will be listed here.
Abstract

BACKGROUND Kidneys from deceased donors who were positive for hepatitis C virus (HCV) on a nucleic acid amplification test (NAT) are not given to anti-HCV antibody-negative recipients. This is because of the high risk of HCV transmission, combined with the lack of effective antiviral treatment. Several studies have demonstrated rates of transmission of HCV from anti-HCV-positive/HCV NAT-positive donors to anti-HCV-negative recipients of 100%. Ours is the first report of transplantation of a kidney from an anti-HCV antibody-positive/HCV NAT-positive donor into an anti-HCV antibody-negative recipient who remains anti-HCV antibody-negative at 3 months after transplant with no treatment. CASE REPORT A 49-year-old man had a history of end-stage renal disease that was presumed to be secondary to type ll diabetes. He received a kidney from a deceased donor who was HCV antibody-positive/NAT-negative. The patient's HCV antibody status was checked prior to transplant and he was found to be negative and nonreactive. Since the transplant, his HCV viral load has been checked 5 times, on postoperative days 15, 23, 44, 62, and 64; each time, it has been undetectable. Furthermore, the patient's HCV antibody status was rechecked 1 month after transplant and it remained negative and nonreactive. CONCLUSIONS Further research is required on the accuracy of polymerase chain reaction as an indicator of donor HCV infection when the quantity of the viral load is not reported.

References
1.
Humar A, Morris M, Blumberg E, Freeman R, Preiksaitis J, Kiberd B . Nucleic acid testing (NAT) of organ donors: is the 'best' test the right test? A consensus conference report. Am J Transplant. 2010; 10(4):889-899. DOI: 10.1111/j.1600-6143.2009.02992.x. View

2.
Kling C, Perkins J, Landis C, Limaye A, Sibulesky L . Utilization of Organs From Donors According to Hepatitis C Antibody and Nucleic Acid Testing Status: Time for Change. Am J Transplant. 2017; 17(11):2863-2868. DOI: 10.1111/ajt.14386. View

3.
Nowak K, Witzke O, Sotiropoulos G, Benko T, Fiedler M, Timm J . Transplantation of Renal Allografts From Organ Donors Reactive for HCV Antibodies to HCV-Negative Recipients: Safety and Clinical Outcome. Kidney Int Rep. 2017; 2(1):53-59. PMC: 5678640. DOI: 10.1016/j.ekir.2016.09.058. View

4.
Dao A, Cuffy M, Kaiser T, Loethen A, Cafardi J, Luckett K . Use of HCV Ab+/NAT- donors in HCV naïve renal transplant recipients to expand the kidney donor pool. Clin Transplant. 2019; 33(7):e13598. DOI: 10.1111/ctr.13598. View

5.
de Vera M, Volk M, Ncube Z, Blais S, Robinson M, Allen N . Transplantation of hepatitis C virus (HCV) antibody positive, nucleic acid test negative donor kidneys to HCV negative patients frequently results in seroconversion but not HCV viremia. Am J Transplant. 2018; 18(10):2451-2456. DOI: 10.1111/ajt.15031. View