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HCV-Positive Organ Donors In patients without hepatitis C virus infection who received a heart or lung from HCV-infected donors, 4 weeks of antiviral treatment initiated after surgery rendered all 35 recipients who had completed 6 months of follow-up free of HCV infection despite early signs of infection in 96% of the recipients within hours after surgery.
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Viral hepatitis remains the leading cause of liver failure and is the primary indication for liver transplantation worldwide. Hepatitis viruses are categorized into five distinct subtypes that collectively render significant morbidity and mortality in transplanted patients. Each subtype has a distinct replication pattern, pathology, and treatment. While the primary pathology mediated by these viruses occurs within the liver, significant extrahepatic disease may be observed with particular...
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These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of viral hepatitis in the pre- and post-transplant period. The current guidelines reflect the declining need for hepatitis B immunoglobulin following liver transplant, now replaced with nucleos(t)ide analogues that effectively suppress viral replication for the long term with minimal risk for drug resistance. It describes the...
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Historically, potential lung donors who have detectable antibodies to hepatitis C virus have been declined by most centers due to concern for possible disease transmission. We sought to evaluate hepatitis C viral transmission rates from donors who were known to be HCV Ab positive but HCV NAT negative. We performed a single-center retrospective review of a prospectively collected database for lung transplant recipients at our center including HCV Ab+NAT- donors (approved January 2017). Donor...
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<h3>BACKGROUND</h3><p>Hepatitis C (HCV) donors are rarely used for cardiac transplantation due to historically poor outcomes. In 2015, nucleic acid testing (NAT) for viral load was added to the routine work-up of organ donors, allowing for the distinction between subjects who remain viremic (HCV Ab<sup>+</sup>/NAT<sup>+</sup>) and those who have cleared HCV and are no longer viremic (HCV Ab<sup>+</sup>/NAT<sup>–</sup>). The American Society of Transplantation recently recommended that HCV...
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<h2>Summary</h2><p>Viral hepatitis affects millions of people worldwide, and host immunity is the key determinant of patient outcome. Viral hepatitis can be life threatening in patients with haematological malignancy, including haemopoietic stem cell transplant recipients, because of the virus itself, or through a need to decrease the dose of chemotherapy. A past or currently infected haemopoietic stem cell donor could also transmit viral hepatitis. The burden of viral hepatitis in patients...
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There are limited data regarding heart transplantation in the setting of hepatitis C virus (HCV) infection in either recipients or donors, as the practice was infrequent, given concerns of worse post-transplant outcomes. This changed dramatically after the development of highly effective HCV therapies, namely direct-acting antivirals (DAAs). Additionally, nucleic acid testing currently in use establishes more precisely the risk of HCV transmission from donors. As a result, chronic HCV...
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