Willingness of Kidney and Liver Transplant Candidates to Receive HCV-Infected Organs

Cohen, Stephanie G.; Cowan, Vanessa; Rohan, Vinayak; Pavlakis, Martha; Curry, Michael P.; Adler, Joel T.; Safa, Kassem; Fleishman, Aaron; Shenkel, Jessica; Rodrigue, James R.

doi:10.1016/j.jss.2022.05.003

Cited by 3 publications

(3 citation statements)

References 30 publications

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“…A shortening of wait-time on the list was also seen in this analysis. The importance of education regarding risks/benefits and therapeutic options following transplantation with an HCV+ organ was highlighted by another study surveying 435 kidney and liver transplant candidates at four different centers [15]. In this study, the willingness to accept HCV+ organs increased from 58 to 86% with such education.…”

Section: Willingness To Accept Hepatitis C Virus-positive Kidneysmentioning

confidence: 99%

“…In this study, the willingness to accept HCVþ organs increased from 58 to 86% with such education. Factors like older age, longer waiting time, trust in the transplant system, willingness to accept an organ from an intravenous drug user and previous awareness of DAAs all were positively associated with an increased willingness to accept an HCVþ organ [15]. Furthermore, the most important reasons for accepting an HCVþ organ were decrease in waiting time (65%), less risk of mortality and morbidity while on the waitlist (63%), effectiveness of HCVþ therapy (54%), and a faster return to functional status (51%).…”

Section: Key Pointsmentioning

confidence: 99%

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Utilization of hepatitis C virus-positive donors in kidney transplantation

Shetty

Ariyamuthu

Gungor

et al. 2022

Current Opinion in Organ Transplantation

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Purpose of reviewDirect-acting antivirals (DAA) have transformed kidney transplantation by increasing the donor pool from hepatitis C virus (HCV)-infected donors and allowing HCV nucleic acid amplification testing (NAT) donorpositive/recipient-negative (Dþ/R-) transplantation over the last 7 years. Willingness to accept kidneys from HCV-infected donors and timing/duration of DAA therapy have been evolving. Recent findingsBy 2021, most of the HCV NATþ kidneys (92.6%) were transplanted to HCV-naive recipients. Despite the availability of effective DAA therapy, the discard rate of HCV NAT kidneys has been stagnant around 25%. The proportion of wait-listed patients willing to accept a deceased donor kidney from HCV Abþ and HCV NATþ donors increased 20-fold between 2015 and 2022. Wait-listed time to receive HCV NATþ kidneys has been rising and most of the kidneys are transplanted to HCV-naive recipients. The proportion of deceased donor kidney transplants performed in recipients with HCV seropositivity decreased from 5.1 to 2.8% during the same period. Relatively short courses of DAA therapy (7--8 days) appear to be effective to decrease HCV transmission (<5%) and achieve sustained virological response at 12 weeks if administered prior to revascularization. SummaryFurther studies are needed to evaluate long-term outcomes of HCV NAT Dþ/RÀ transplantation and the best course of DAA treatment.

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Section: Willingness To Accept Hepatitis C Virus-positive Kidneysmentioning

confidence: 99%

Section: Key Pointsmentioning

confidence: 99%

Utilization of hepatitis C virus-positive donors in kidney transplantation

Shetty

Ariyamuthu

Gungor

et al. 2022

Current Opinion in Organ Transplantation

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“…Obstacles to broader uptake include concerns about insurance coverage for DAA treatment and perceived risk of disease transmission [89]. Patient education on the risks and benefits of HCV+ to HCV- transplantation has been shown to increase willingness to consider such offers [90].…”

Section: Hcv+ Kidneysmentioning

confidence: 99%

Beyond donation to organ utilization in the USA

Stewart

Lonze

2023

Current Opinion in Organ Transplantation

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Purpose of reviewThe deceased donor organ pool has broadened beyond young, otherwise healthy head trauma victims. But an abundance of donated organs only benefits patients if they are accepted, expeditiously transported and actually transplanted. This review focuses on postdonation challenges and opportunities to increase the number of transplants through improved organ utilization. Recent findingsWe build upon recently proposed changes in terminology for measuring organ utilization. Among organs recovered for transplant, the nonuse rate (NUR REC ) has risen above 25% for kidneys and pancreata. Among donors, the nonuse rate (NUR DON ) has risen to 40% for livers and exceeds 70% for thoracic organs. Programme-level variation in offer acceptance rates vastly exceeds variation in the traditional, 1-year survival benchmark. Key opportunities to boost utilization include donation after circulatory death and hepatitis C virus (HCV)þ organs; acute kidney injury and suboptimal biopsy kidneys; older and steatotic livers.

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Shifting perspectives in liver diseases after kidney transplantation

Košuta¹,

Ostojić²,

Brajković³

et al. 2023

World J Hepatol

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Metabolic-associated fatty liver disease (MAFLD) is one of the most common chronic liver diseases worldwide. In recent years, the occurrence rate of MAFLD has been on the rise, mainly due to lifestyle changes, high-calorie diets, and imbalanced dietary structures, thereby posing a threat to human health and creating heavy social and economic burdens. With the development of 16S sequencing and integrated multi-omics analysis, the role of the gut microbiota (GM) and its metabolites in MAFLD has been further recognized. The GM plays a role in digestion, energy metabolism, vitamin synthesis, the prevention of pathogenic bacteria colonisation, and immunoregulation. The gut-liver axis is one of the vital links between the GM and the liver. Toxic substances in the intestine can enter the liver through the portal vascular system when the intestinal barrier is severely damaged. The liver also influences the GM in various ways, such as bile acid circulation. The gut-liver axis is essential in maintaining the body’s normal physiological state and plays a role in the onset and prognosis of many diseases, including MAFLD. This article reviews the status of the GM and MAFLD and summarizes the GM characteristics in MAFLD. The relationship between the GM and MAFLD is discussed in terms of bile acid circulation, energy metabolism, micronutrients, and signalling pathways. Current MAFLD treatments targeting the GM are also listed.

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Willingness of Kidney and Liver Transplant Candidates to Receive HCV-Infected Organs

Cited by 3 publications

References 30 publications

Utilization of hepatitis C virus-positive donors in kidney transplantation

Utilization of hepatitis C virus-positive donors in kidney transplantation

Beyond donation to organ utilization in the USA

Shifting perspectives in liver diseases after kidney transplantation

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