title: Expanding access to transplantation with hepatitis C-positive donors: A new perspective on an old issue.
abstract: With the need for organs far exceeding supply, donors previously exposed to hepatitis B (HBV) and hepatitis C (HCV) viral infections should be considered for transplantation. Although many centers have protocols for transplanting organs from HBV core antibody-positive (HBcAb+) donors into select recipients, in the era of direct-acting antivirals (DAAs), a new focus should be placed on HCV-positive donors. The transmission rate from HCV antibody-positive (HCVAb+) nucleic acid testing negative (HCV NAT-) donors is expected to be very low, and we encourage use of such organs in HCV recipients provided a normal biopsy, appropriate counseling, and careful post-transplant monitoring. While transmission of HCV from HCV NAT+ donors is universal, the success of DAA in obtaining a sustained viral response in post-transplant recipients should make the use of these organs more appealing. We herein provide information to help guide the use of organs from HCV donors.
authors.affiliation: Division of Transplant Surgery, Department of Surgery, University of Washington, Seattle, WA, USA.
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Kling
authors.affiliation: Division of Allergy and Infectious Disease, Department of Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Ajit P
authors.initials: AP
authors.lastname: Limaye
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Charles S
authors.initials: CS
authors.lastname: Landis
authors.affiliation: Division of Transplant Surgery, Department of Surgery, University of Washington, Seattle, WA, USA.
authors.forename: Lena
authors.initials: L
authors.lastname: Sibulesky
mesh_terms: D016174:Hepacivirus / Q000502:physiology*; D006526:Hepatitis C / Q000188:drug therapy / Q000635:transmission* / Q000821:virology; D006801:Humans; D016377:Organ Transplantation / Q000706:statistics & numerical data*; D011379:Prognosis; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000379:methods*
keywords: hepatitis C donor; liver transplant; organ shortage