DETECTION OF HEPATITIS C ANTIBODIES IN KIDNEY TRANSPLANT RECIPIENTS FROM A DECEASED DONOR PREVIOUSLY TREATED FOR HEPATITIS C

N AGARWAL1, R DAVIS 2, J WONG 3, S STRASSER4, K KABLE5, G WONG5, B NANKIVELL5, K WYBURN 1,6

1Renal Department of Royal Prince Alfred Hospital, Camperdown, NSW; 2Department of Infectious Disease and Microbiology, Royal Prince Alfred Hospital, Camperdown, NSW; 3Renal Department of Liverpool Hospital, Liverpool, NSW; 4AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Camperdown, NSW; 5Renal Department of Westmead Hospital, Westmead, NSW; 6University of Sydney, Sydney, NSW.

Background: The introduction of Direct Acting Anti-viral (DAA) treatment for Hepatitis C virus (HCV) has led to the potential to transplant organs from donors previously treated for HCV into HCV negative recipients.

Case report: We report a case of two kidney recipients who were HCV negative at the time of transplant. Both received a transplant from a 55 year old deceased donor with a past history of Hepatitis C who was treated for 12 weeks with ledipasvir/sofosbuvir and achieved a sustained viral response (SVR). At the time of organ retrieval, the donor was HCV antibody (anti-HCV) positive but negative for HCV RNA by nucleic acid testing (NAT). Both kidney recipients on routine screening had newly detected anti-HCV at Day 31 (left kidney recipient) and Day 99 (right kidney recipient) post transplant, but they remained HCV RNA negative. At 6 months post transplant both have normal liver function, excellent graft function (creatinine 130umol/l and 135umol/L respectively), with no episodes of rejection nor proteinuria, and they remain anti-HCV positive and HCV RNA negative. Neither kidney recipient had high-risk behaviours or healthcare exposures such as blood products to suggest an alternative source of transmission. The lungs were transplanted into an anti-HCV positive, HCV RNA negative recipient who has remained HCV RNA negative post transplant.

Conclusions: To our knowledge, this is the first description of HCV antibody detection in kidney recipients who received an organ from an anti-HCV positive donor who had successful treatment with a DAA. As there is no evidence to suggest HCV infection of the recipients, we hypothesise that these HCV antibodies are derived from donor passenger leucocytes.

About ANZSN

The ASM is hosted by Australian and New Zealand Society of Nephrology.

The aims of the Society are to promote and support the study of the kidney and urinary tract in health and disease, and to ensure the highest professional standards for the practice of nephrology in Australia and New Zealand.

Conference Managers

Please contact the team at Conference Design with any questions regarding the conference.
/wp-content/uploads/2017/08/Conference-Design-400x400.png
© 2015 - 2016 Conference Design Pty Ltd