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Transplanting hepatitis C-infected kidneys into uninfected recipients
Waiting times for renal transplant exceed 3–5 years in many parts of the USA; yet, more than 500 high-quality kidneys from hepatitis C virus (HCV)-infected deceased donors are discarded annually. At the University of Pennsylvania, Goldberg et al 1 carried out an open-label, single-group pilot trial to determine safety and efficacy of transplantation of HCV genotype 1 viraemic donors into HCV-negative patients, followed by treatment with elbasvir-grazoprevir (Zepatier). Adults undergoing dialysis who had long anticipated waiting times for transplant were eligible and those with conditions that increased the risk of liver disease, allograft failure or mortality were excluded. HCV-viral load was measured in recipients on day 3 postoperatively and elbasvir-grazoprevir initiated when HCV-viral load became positive for 12 weeks. Thirty-eight patients were screened and 10 received HCV-infected kidneys, median age was 59, 50% male, two black. All patients were cured of HCV, defined as a sustained virological response …
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