Trends in Renal Function Among Heart Transplant Recipients of Donor-Derived Hepatitis C Virus

Donor-derived hepatitis C (dd-HCV) infection may increase the risk of renal impairment (RI) among heart transplantation (HT) recipients. Sofosbuvir, an integral component of HCV direct-acting antivirals (DAAs) has also been linked to RI. To date, no study has examined the trends in renal function for HT recipients of dd-HCV infection and assessed safety and efficacy of Sofosbuvir-based DAAs. Between September 2016 and June 2018, 46 HCV-naive patients and one patient with a history of HCV treated pretransplant, underwent HT from HCV-positive donors (follow-up available through October 10, 2018). Patients were treated with Ledipasvir-Sofosbuvir (genotype 1) or Sofosbuvir-Velpatasvir (genotype 3) for 12 or 24 weeks; no dose adjustments were made for renal function. Data on renal function were available for 23 patients who achieved a sustained virologic response at 12 weeks after the treatment (SVR12; cohort A) and 18 patients who completed 1 year of follow-up (cohort B). Treatment of dd-HCV infection was initiated at a median of 6 weeks post-HT. In both cohorts, a nonsignificant reduction in median estimated glomerular filtration rate (eGFR; ml/min/1.73 m2) was noted (cohort A: pretransplant eGFR: 62 [interquartile range {IQR}: 1–84] to SVR12 eGFR: 49 [IQR: 37–82]; p = 0.43; cohort B: pretransplant eGFR: 65 [IQR: 54–84] to 1 year post-HT eGFR: 56 [IQR: 39–75]; p = 0.29). Pretreatment renal function had no significant impact on changes in renal function during treatment. ...
Source: ASAIO Journal - Category: Medical Devices Tags: Clinical Cardiovascular Source Type: research