Pathological Consequences in Anti-HCV Antibody-Positive Organ Donation to an Anti-HCV Antibody-Negative Recipient

Abstract

BackgroundThe need to expand the pool of available organs has meant that the use of marginal organs is increasingly widespread. With the advent of antiviral therapy for hepatitis C, it has made it possible to consider the donation of organs from HCV positive donors or even from viremic donors. MethodsIn HCV positive to HCV negative antibody donor transplantation, the development of antibodies to HCV is documented unevenly depending on the organ transplanted and with differences in the time of appearance and in some cases with subsequent disappearance that draws attention to the fact whether it is the development of antibodies or the transmission of immunity between donor and recipient. In transplantation from HCV infected donor to negative recipient the introduction pre-transplantation or a few days after transplantation of antiviral therapy into the recipient achieves sustained response in almost all cases. We wanted to deepen the argument by studying the literature data, focusing on kidney transplantation, in consideration of the fact that this could be of interest in particular for the possible long-term renal damage. ResultsHCV infection both ongoing and past but also the presence of HCV antibodies alone can be responsible for kidney damage. ConclusionsDAA therapy has revolutionized the history of HCV disease and the therapeutic possibilities of transplantation. However, we believ it is useful to keep in mind the pathophysiology of HCV-related damage especially in patients with long life expectancy, using all emerging strategies to minimize the risk of transmission of infection or development of viremia.