Methylene blue (MB) treatment of the kidneys during cold ischemia time may reduce the risk for hepatitis C virus (HCV) transmission during transplantation, according to the results from a proof of concept study published in The Journal of Infectious Diseases.1
Recently, a pilot trial showed that the transplantation of HCV genotype 1-positive kidneys into HCV-negative recipients followed by antiviral therapy can provide a cure for the HCV infection.2
Standard virologic assays were used to investigate the effect of antivirals, including MB, in different organ preservation solutions. Kidneys from pigs were contaminated with HCV RNA-positive human serum. Afterwards, organs were flushed with MB. Hypothermic machine perfusion was used to optimize the reduction of HCV.
Of the 3 different antivirals investigated for their ability to inactivate HCV in vitro, only MB completely inactivated HCV in the presence of all perfusion solutions.
The reduced infectivity after the procedure was confirmed using human liver-uPA-SCID mice.
This is the first study to show that treatment of organs exposed to HCV may be possible in the transplant setting, potentially increasing the pool of organs available for donation.
1. Helfritz FA, Bojkova D, Wanders V. Methylene Blue treatment of grafts during cold ischemia time reduces the risk of HCV transmission [published online June 23, 2018]. J Infect Dis. doi:10.1093/infdis/jiy386
2. Goldberg DS, Abt PL, Reese PP. Transplanting HCV-infected kidneys into uninfected recipients. N Engl J Med. 2017;377(11):1105.