Expanding Pool of Eligible Kidney Donors With DAA Prophylaxis for Hepatitis C

DAA prophylaxis for non-HCV positive recipients of kidneys from HCV-positive donors may be a safe strategy to increase the pool of organs eligible for transplant.

Pre- and post-transplant direct-acting antiviral (DAA) prophylaxis safely and effectively prevented chronic hepatitis C infection in kidney transplants in hepatitis C-infected donors, according to results published in the Annals of Internal Medicine.

“If confirmed in larger studies, this strategy should markedly expand organ options and reduce mortality for kidney transplant candidates without HCV infection,” the researchers wrote.

The study included 10 hepatitis C-negative kidney transplant candidates with no available living donors. Each candidate received a transplant of a kidney from a deceased donor age 13 to 50 with positive hepatitis C RNA and hepatitis C antibody test results. All recipients received grazoprevir 100 mg and elbasvir 50 mg immediately before transplant.

Recipients who received kidneys from donors with hepatitis C genotype 1 infection continued receiving grazoprevir/elbasvir for 12 weeks after the transplant. Recipients who received kidneys from donors with hepatitis C genotype 2 or 3 infection received grazoprevir/elbasvir plus sofosbuvir 400 mg for 12 weeks after transplant.

No treatment-related adverse events occurred in any of the participants. Hepatitis C RNA was not detected in any recipient 12 weeks after treatment.


Full list of author disclosures can also be viewed here.

Related Articles


Durand CM, Bowring MG, Brown DM, et al. Direct-acting antiviral prophylaxis in kidney transplantation from hepatitis C virus-infected donors to noninfected recipients [published online March 6, 2018]. Ann Intern Med. doi:10.7326/M17-2871