title: Successful Recovery of Acute Renal Transplant Failure in Recurrent Hepatitis C Virus-Associated Membranoproliferative Glomerulonephritis.
abstract: Recurrence of hepatitis C virus (HCV)-associated membranoproliferative glomerulonephritis (MPGN) in the kidney transplant may lead to continuous graft deterioration and the need for further renal replacement therapy. The novel direct-acting antiviral agents (DAAs) allow a highly effective and interferon-free treatment option for chronic HCV-infected patients. Data on the therapeutic safety and efficacy in HCV-infected renal transplant patients are sparse, especially for patients with severe renal impairment. We report the case of a 63-year-old female HCV-positive renal transplant patient with biopsy-proven recurrence of MPGN in the renal graft 3 years after transplant. Because of rapid loss of transplant function and consecutive need for hemodialysis, we initiated a combined anti-HCV-directed therapy regimen consisting of daclatasvir and simeprevir over 12 weeks. Viral clearance of HCV was obtained as early as 2 weeks after start of treatment. No adverse therapy-associated side effects were observed, and immunosuppressive dosing remained unchanged. Importantly, graft function fully recovered and hemodialysis was stopped 2 mo after the end of daclatasvir/simeprevir treatment. We report the first case of successful recovery of dialysis-dependent renal transplant failure after treatment of recurrent HCV-associated MPGN in a kidney transplant recipient by curing the underlying HCV infection with a combination of novel DAAs.
authors: Division of Nephrology, Department of Internal Medicine, Charité-Universitätsmedizin Berlin Campus Mitte, Berlin, Germany.
authors: E
authors: E
authors: Schrezenmeier
authors: Department of Pathology, Charité-Universitätsmedizin Berlin Campus Mitte, Berlin, Germany.
authors: K
authors: K
authors: Wu
authors: Division of Nephrology, Department of Internal Medicine, Charité-Universitätsmedizin Berlin Campus Mitte, Berlin, Germany.
authors: F
authors: F
authors: Halleck
authors: Division of Nephrology, Department of Internal Medicine, Charité-Universitätsmedizin Berlin Campus Mitte, Berlin, Germany.
authors: L
authors: L
authors: Liefeldt
authors: Division of Nephrology, Department of Internal Medicine, Charité-Universitätsmedizin Berlin Campus Mitte, Berlin, Germany.
authors: S
authors: S
authors: Brakemeier
authors: Division of Nephrology, Department of Internal Medicine, Charité-Universitätsmedizin Berlin Campus Mitte, Berlin, Germany.
authors: F
authors: F
authors: Bachmann
authors: Division of Nephrology, Department of Internal Medicine, Charité-Universitätsmedizin Berlin Campus Mitte, Berlin, Germany.
authors: S
authors: S
authors: Kron
authors: Division of Nephrology, Department of Internal Medicine, Charité-Universitätsmedizin Berlin Campus Mitte, Berlin, Germany.
authors: K
authors: K
authors: Budde
authors: Division of Nephrology, Department of Internal Medicine, Charité-Universitätsmedizin Berlin Campus Mitte, Berlin, Germany.
authors: M
authors: M
authors: Duerr
mesh_terms: D058186:Acute Kidney Injury / Q000601:surgery*; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D005919:Glomerular Filtration Rate; D015432:Glomerulonephritis, Membranoproliferative / Q000188:drug therapy* / Q000209:etiology; D006084:Graft Rejection / Q000188:drug therapy* / Q000209:etiology; D006085:Graft Survival / Q000187:drug effects; D016174:Hepacivirus / Q000472:pathogenicity*; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents
keywords: antibiotic: antiviral; clinical research/practice; infection and infectious agents; infectious disease; viral: hepatitis C