{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T23:34:24Z","timestamp":1785368064948,"version":"3.55.0"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"Supplement_4","license":[{"start":{"date-parts":[[2022,6,8]],"date-time":"2022-06-08T00:00:00Z","timestamp":1654646400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>Direct-acting antivirals (DAAs) allow for successful transplantation of livers from hepatitis C nucleic acid test (NAT)\u2013positive donors to negative recipients. However, limited data exist to support crushing DAAs in patients with multiple absorption concerns or significant drug interactions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Summary<\/jats:title>\n                  <jats:p>Crushed sofosbuvir\/velpatasvir has been successfully used in nontransplant patients with dysphagia, but data in transplant patients with absorption concerns are limited. A 31-year-old hepatitis C\u2013negative female underwent liver transplantation from a hepatitis C NAT\u2013positive donor. Her postoperative course was complicated by a mucormycosis infection, gastrointestinal bleed, and necrotizing pancreatitis requiring treatment with liposomal amphotericin B and pantoprazole 80 mg twice daily. Surgical interventions included an above-the-knee amputation and ileostomy. Hepatitis C treatment was initially delayed because of concern for reduced absorption with crushed DAA administration through the nasogastric (NG) tube, high ileostomy output, gastrointestinal bleed, pancreatitis, and a known drug interaction with pantoprazole. One month after transplantation, the patient\u2019s bilirubin level remained elevated and hepatitis C treatment was initiated with sofosbuvir\/velpatasvir. Crushed sofosbuvir\/velpatasvir was mixed with 30 mL of water and administered through the NG tube daily. Hepatitis C viral loads were obtained weekly during treatment to monitor efficacy. Although the patient died before evaluation of sustained virological response at 12 weeks, hepatitis C viral clearance was observed within 4 weeks of initiating treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>A liver transplant patient exhibited viral clearance of hepatitis C following administration of crushed sofosbuvir\/velpatasvir in the setting of multiple absorption concerns.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajhp\/zxac153","type":"journal-article","created":{"date-parts":[[2022,6,8]],"date-time":"2022-06-08T18:20:05Z","timestamp":1654712405000},"page":"S101-S105","source":"Crossref","is-referenced-by-count":2,"title":["Hepatitis C viral clearance with coadministration of crushed sofosbuvir\/velpatasvir and high-dose pantoprazole after liver transplantation"],"prefix":"10.1093","volume":"79","author":[{"given":"Dawn M","family":"Pluckrose","sequence":"first","affiliation":[{"name":"Department of Pharmacy, NYU Langone Health , New York, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Szczepanik","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Maryland Medical Center , Baltimore, MD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E","family":"Bova","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Maryland Medical Center , Baltimore, MD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sari R","family":"Freedman","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Maryland Medical Center , Baltimore, MD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,6,8]]},"reference":[{"key":"2022112209342716300_CIT0001","author":"American"},{"key":"2022112209342716300_CIT0002","volume-title":"Epclusa (sofosbuvir and velpatasvir). 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