One-year immunologic outcomes of lung transplantation utilizing hepatitis C-viremic donors

被引：5

作者：

Lewis, Tyler C. ^{[1
]}

Lesko, Melissa ^{[1
]}

Rudym, Darya ^{[1
]}

Lonze, Bonnie E. ^{[1
]}

Mangiola, Massimo ^{[1
]}

Natalini, Jake G. ^{[1
]}

Chan, Justin C. Y. ^{[2
]}

Chang, Stephanie H. ^{[2
]}

Angel, Luis F. ^{[1
]}

机构：

[1] NYU Langone Hlth, Transplant Inst, New York, NY USA

[2] NYU Langone Hlth, Dept Cardiothorac Surg, New York, NY USA

来源：

CLINICAL TRANSPLANTATION | 2022年 / 36卷 / 08期

关键词：

infection and infectious agents; rejection: acute; viral: hepatitis C; ORGAN DONORS; IMPACT; SEROPOSITIVITY; RECIPIENTS; INFECTION; REJECTION; HEART;

D O I：

10.1111/ctr.14749

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Little is known about the effects of hepatitis C viremia on immunologic outcomes in the era of direct-acting antivirals. We conducted a prospective, single-arm trial of lung transplantation from hepatitis C-infected donors into hepatitis C-naive recipients (n = 21). Recipients were initiated on glecaprevir-pibrentasvir immediately post-transplant and were continued on therapy for a total of 8 weeks. A control group of recipients of hepatitis C-negative lungs were matched 1:1 on baseline variables (n = 21). The primary outcome was the frequency of acute cellular rejection over 1-year post-transplant. Treatment with glecaprevir-pibrentasvir was well tolerated and resulted in viremia clearance after a median of 16 days of therapy (IQR 10-24 days). At one year, there was no difference in incidence of acute cellular rejection (71.4% vs. 85.7%, P = .17) or rejection requiring treatment (33.3% vs. 57.1%, P = .12). Mean cumulative acute rejection scores were similar between groups (.46 [SD +/- .53] vs. .52 [SD +/- .37], P = .67). Receipt of HCV+ organs was not associated with acute rejection on unadjusted Cox regression analysis (HR .55, 95% CI .28-1.11, P = .09), or when adjusted for risk factors known to be associated with acute rejection (HR .57, 95% CI .27-1.21, P = .14). Utilization of hepatitis C infected lungs with immediate treatment leads to equivalent immunologic outcomes at 1 year.

引用

页数：8