New method offers hope for patients with a significant need for kidney transplants

Reviewed by Emily Henderson, B.Sc.September 2, 2020

Massachusetts General Hospital (MGH) studies show that kidneys from hepatitis C virus (HCV)-infected dead donors are not infected when a direct-acting antiviral therapy regimen is initiated 2 days after transplantation. Can be safely ported to the recipient. ..

In a multicenter clinical trial, Journal of American Nephrology SocietyMGH researchers found that each of 30 kidney recipients healed HCV and had no serious side effects due to antiviral therapy, and almost all maintained excellent allograft function at 6 months. I have found

We successfully treated kidney-transplanted hepatitis C virus from HCV-positive donors with the antiviral drugs grecaprevir and pibrentavir as part of daily dosing for 8 weeks.

These findings could convey a strong message to many transplant centers that are still vigilant or resistant to kidney use from HCV-infected donors. These so-called donor-positive to recipient-negative transplants have been shown to be safe and effective through early antiviral intervention. “

Meghan Sise, MD, Massachusetts General Hospital, Nephrology, Co-author and Investigator

Currently, approximately 95,000 people in the United States await kidney transplants, most of whom suffer from progressive health deterioration. Deaths are more certain than transplants in some groups, including patients over the age of 60.

In light of this significant public health issue, the US Department of Health and Human Services has set a goal to double the number of transplantable kidneys by 2030 as part of the Advancing American Kidney Health Initiative.

One promising route to that target is to reduce currently occurring viable human kidney disposal, especially from deceased individuals with hepatitis C virus infection. The numbers of these organs have skyrocketed over the last five years as a result of the increased deaths from the national opioid outbreak.

The MGH prospective trial is the first multicenter study to demonstrate the feasibility of donor-positive and donor-negative transplants. Known as MYTHIC (a multicenter study of transplanting kidneys infected with hepatitis C), this study was designed and conducted in collaboration with the University of Pennsylvania’s Perelman School of Medicine.

Formulation of Grecaprevir and Pibrentavir, potent antiviral agents targeting two different proteins in the virus essential for survival in each of 30 kidney recipients in a study conducted at seven transplant centers in the United States 8 weeks course was given.

One patient died of a complication of sepsis that was considered unrelated to study participation, but no serious side effects or liver disease was observed in any patient, and allograft function was superior for 6 months.

“Many patients had a small amount of virus in their blood immediately after transplantation, which Viral load Was undetectable or unquantifiable in all recipients of HCV viremia kidney by 4 weeks of treatment,” said MGH’s Liver Center and Gastrointestinal Department investigator, co-authored in the study. Said Dr. Raymond Chung.

The success of this study extends to the development of evidence-based clinical protocols by research centers, where hepatitis C-infected kidneys are transplanted anywhere transplant centers can use.

“We sought to replace many homemade protocols based on different treatment regimens with reliable, uniform and reproducible protocols,” explains Chung. “We believe we have succeeded in creating a very simple approach that works in patients.”

Researchers now hope that transplant centers will be aware of these promising results and the opportunity to increase access to quality organs by patients in need of kidney transplants. “By showing that these steps are effective,” says Shise,

“I hope that insurance companies will see the great benefit of evenly reimbursable transplants for hepatitis C-infected kidneys. Everyone’s ultimate goal is to wait for kidney transplants. To increase the quality and quantity of life of patients who are suffering.”