P8.114: Recurrence Rate of Early HCV Infection After Renal Transplantation Following Successful Treatment of Dialysis Patients With Direct Acting Antiviral Agents

Abstract

Introduction: HCV recurrence after organ transplantation has dreadful complications. Excellent response of direct acting antiviral agents (DAAs) in transplant recipients has been reported in various studies. Although, sustained virological response is considered as the virological cure, but it requires patients to be further 3 months on dialysis before undergoing renal transplant.Thus, increasing risk of HCV re-infection and associated complications. We aim to determine HCV recurrence in renal transplant recipients (RTRs) who has achieved end of treatment response (ETR) before transplant. Methods and Materials: As per institutional protocol dialysis patients who failed to achieve rapid virological response (RVR) were treated with 6 months of DAAs. All patients who have achieved ETR were then referred for transplantation. Kidney transplant recipients who were treatment experience with DAAs and had a HCV PCR done 3 months after transplant was enrolled. Participant’s demographic and clinical data was documented and statistical analysis was performed by SPSS 20.0. Results: In total 40 transplant recipients were included, majority were males (81.1%) with mean age of 28.7 ± 9.4 years. All patients had received sofosbuvir, daclatasavir and ribavirin combination prior to transplant. Majority of patients received treatment for 3 months (70%). Only 5 % of study population did not achieved RVR while all patients achieved ETR. Two patients also had treatment experience with interferon. Post-transplant HCV PCR was conducted at mean duration of 8.3 ± 3.3 months. Laboratory parameters showed Total Bilirubin 3.6 ± 17.5 mg/d, Alanine transaminase 51.5 ± IU/L 80.2 and gamma glutamyl transferase of 133.9 ± 220 IU/L. Post renal transplant HCV recurrence was documented in 2 (5%) recipients. Conclusion: This is first study to document excellent response of DAAs in renal transplant recipients who has been referred early for transplant. Thus, dialysis patients can undergo transplant after achieving end of treatment response.