{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T11:30:38Z","timestamp":1790767838826,"version":"4.1.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2021,1,22]],"date-time":"2021-01-22T00:00:00Z","timestamp":1611273600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,1,22]],"date-time":"2021-01-22T00:00:00Z","timestamp":1611273600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n            <jats:title>Background and Aims<\/jats:title>\n            <jats:p>Organs from hepatitis C virus (HCV)\u2010viremic donors have been used in HCV\u2010uninfected recipients (D+\/R\u2010), but the optimal treatment approach has not been defined. We evaluated the kinetics of HCV infection following transplant in D+\/R\u2010 kidney\u2010transplant (KT) and liver\u2010transplant (LT) recipients when a preemptive antiviral strategy was used.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results<\/jats:title>\n            <jats:p>Six US transplant programs prospectively treated D+\/R\u2010 primary LT and KT recipients with sofosbuvir\u2010velpastasvir for 12\u00a0weeks starting once viremia was confirmed following transplant and the patients were judged to be clinically stable, including estimated glomerular filtration rate &gt;30\u00a0mL\/min. Primary endpoints were sustained virologic response at 12\u00a0weeks following transplant and safety (assessed by proportion of treatment\u2010related adverse and serious adverse events). Of the 24 patients transplanted (13 liver, of whom 2 had prior\u2010treated HCV infection; 11 kidney), 23 became viremic after transplant. The median (interquartile range) time from transplant to start of antiviral therapy was 7.0 (6.0, 12.0) versus 16.5 (9.8, 24.5) days, and the median (interquartile range) HCV\u2010RNA level 3\u00a0days after transplant was 6.5 (3.9, 7.1) versus 3.6 (2.9, 4.0) log<jats:sub>10<\/jats:sub>\u00a0IU\/mL in LT versus KT recipients, respectively. By week 4 of treatment, 10 of 13 (77%) LT, but only 2 of 10 (20%) KT, had undetectable HCV RNA (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.01). At the end of treatment, all LT recipients were HCV RNA\u2013undetectable, whereas 3 (30%) of the kidney recipients still had detectable, but not quantifiable, viremia. All achieved sustained virologic response at 12\u00a0weeks following transplant (lower 95% confidence interval bound: 85%). Serious adverse events considered possibly related to treatment were antibody\u2010mediated rejection, biliary sclerosis, cardiomyopathy, and graft\u2010versus\u2010host disease, with the latter associated with multiorgan failure, premature treatment discontinuation, and death.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Despite differing kinetics of early HCV infection in liver versus non\u2010liver recipients, a preemptive antiviral strategy is effective. Vigilance for adverse immunologic events is warranted.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.31551","type":"journal-article","created":{"date-parts":[[2020,9,24]],"date-time":"2020-09-24T12:26:59Z","timestamp":1600950419000},"page":"2110-2123","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":43,"title":["Prospective Multicenter Study of Early Antiviral Therapy in Liver and Kidney Transplant Recipients of HCV\u2010Viremic Donors"],"prefix":"10.1097","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4143-1950","authenticated-orcid":false,"given":"Norah A.","family":"Terrault","sequence":"first","affiliation":[{"name":"Keck Medicine,University of Southern California,Los Angeles,CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Burton","sequence":"additional","affiliation":[{"name":"Department of Medicine,University of Colorado,Denver,CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Ghobrial","sequence":"additional","affiliation":[{"name":"J C Walter Jr Transplant Center,Houston Methodist Hospital,Weil Cornell College of Medicine,Sherrie and Alan Conover Center for Liver Disease and Transplantation,Houston,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Verna","sequence":"additional","affiliation":[{"name":"Department of Medicine,Columbia University College of Physicians & Surgeons,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Bayer","sequence":"additional","affiliation":[{"name":"Annette C. and Harold C. Simmons Transplant Institute,Baylor University Medical Center,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Transplantation,Piedmont Transplant Institute,Atlanta,GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Victor","sequence":"additional","affiliation":[{"name":"J C Walter Jr Transplant Center,Houston Methodist Hospital,Weil Cornell College of Medicine,Sherrie and Alan Conover Center for Liver Disease and Transplantation,Houston,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumit","family":"Mohan","sequence":"additional","affiliation":[{"name":"Department of Medicine,Columbia University College of Physicians & Surgeons,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Trotter","sequence":"additional","affiliation":[{"name":"Annette C. and Harold C. Simmons Transplant Institute,Baylor University Medical Center,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Dodge","sequence":"additional","affiliation":[{"name":"Keck Medicine,University of Southern California,Los Angeles,CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus U.","family":"Niemann","sequence":"additional","affiliation":[{"name":"Department of Anesthesia & Perioperative Care,University of California San Francisco,San Francisco,CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond A.","family":"Rubin","sequence":"additional","affiliation":[{"name":"Department of Transplantation,Piedmont Transplant Institute,Atlanta,GA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,1,22]]},"reference":[{"key":"hep31551-bib-0001-20250824","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1002\/hep.30933","article-title":"Utilization of hepatitis C virus (HCV)\u2010viremic organs for HCV negative recipients: is practice speeding past the evidence?","volume":"71","year":"2020","journal-title":"Hepatology"},{"key":"hep31551-bib-0002-20250824","doi-asserted-by":"crossref","first-page":"2969","DOI":"10.1111\/ajt.15582","article-title":"Lessons from the real world: HCV\u2010infected donor kidney transplantation as standard practice","volume":"19","year":"2019","journal-title":"Am J Transplant"},{"key":"hep31551-bib-0003-20250824","doi-asserted-by":"crossref","first-page":"2790","DOI":"10.1111\/ajt.14381","article-title":"The American Society of transplantation consensus conference on the use of hepatitis C viremic donors in solid 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