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Hepatitis c and organ donor

Wei Tang, Ren Guo, Shi-Jun Shen, Yang Zheng, Yu-Ting Lu, Meng-Meng Jiang, Xue Cui, Ci-Zhong Jiang, Xin Xie
Human liver or hepatocyte transplantation is limited by a severe shortage of donor organs. Direct reprogramming of other adult cells into hepatic cells may offer a solution to this problem. In a previous study, we have generated hepatocyte-like cells from mouse fibroblasts using only one transcription factor (TF) plus a chemical cocktail. Here, we show that human urine-derived epithelial-like cells (hUCs) can also be transdifferentiated into human hepatocyte-like cells (hiHeps) using one TF (Foxa3, Hnf1α, or Hnf4α) plus the same chemical cocktail CRVPTD (C, CHIR99021; R, RepSox; V, VPA; P, Parnate; T, TTNPB; and D, Dznep)...
October 12, 2018: Acta Pharmacologica Sinica
Alanna Carla da Costa, José Damião da Silva Filho, Eduardo Arrais Rocha, Mônica Coelho Andrade, Arduina Sofia Ortet de Barros Vasconcelos Fidalgo, Eliana Régia Barbosa Almeida, Carlos Eduardo Menezes Viana, Erlane Chaves Freitas, Ivo Castelo Branco Coelho, Maria de Fátima Oliveira
INTRODUCTION: The transmission of Chagas disease (CD) through blood transfusion, organ transplantation, and oral transmission has gained greater visibility as a result of intensified vector control activities in endemic regions and to control CD in non-endemic regions. In Brazil, Ceará is one of the states that perform the most organ transplants. Therefore, the objective of this study was to assess the prevalence of Trypanosoma cruzi infection in organ donor candidates. METHODS: A retrospective analysis was performed on data from potential organ donors at the Center of Transplantation of the State of Ceará from 2010 - 2015...
September 2018: Revista da Sociedade Brasileira de Medicina Tropical
Pierluigi Toniutto, Davide Bitetto, Ezio Fornasiere, Elisa Fumolo
Liver transplantation (LT) has become the treatment of choice for a wide range of liver diseases in both adult and pediatric patients. Until recently, the largest proportion of LT in adults, were performed in patients with hepatitis C (HCV) related cirrhosis. The recent availability of safe and effective direct antiviral agents to cure HCV infection in almost all patients whatever the HCV genotype and severity of liver disease, will reduce the need for LT in this category of recipients. Thus, it is presumed that in the next 1 to 2 decades HCV related liver disease will diminish substantially, whereas non-alcoholic steato-hepatitis (NASH) will correspondingly escalate as an indication for LT...
October 5, 2018: Minerva Gastroenterologica e Dietologica
Jessica Lindemann, Leigh Anne Dageforde, Diane Brockmeier, Neeta Vachharajani, Meranda Scherer, William Chapman, Maria B Majella Doyle
Abdominal organ transplantation faces several challenges: burnout, limited pipeline of future surgeons, changes in liver allocation potentially impacting organ procurement travel, and travel safety. The organ procurement center (OPC) model may be one way to mitigate these issues. Liver transplants from 2009 to 2016 were reviewed. There were 755 liver transplants performed with 525 OPC and 230 in-hospital procurements. The majority of transplants (87.4%) were started during daytime hours (5 am-7 pm). Transplants with any portion occurring after-hours were more likely to have procurements in-hospital (P < ...
September 24, 2018: American Journal of Transplantation
Joris J Blok, Hein Putter, Herold J Metselaar, Robert J Porte, Federica Gonella, Jeroen de Jonge, Aad P van den Berg, Josephine van der Zande, Jacob D de Boer, Bart van Hoek, Andries E Braat
Background: Outcome after liver transplantation (LT) is determined by donor, transplant and recipient risk factors. These factors may have different impact on either patient or graft survival (outcome type). In the literature, there is wide variation in the use of outcome types and points in time (short term or long term). Objective of this study is to analyze the predictive capacity of risk factors and risk models in LT and how they vary over time and per outcome type. Methods: All LTs performed in the Netherlands from January 1, 2002, to December 31, 2011, were analyzed with multivariate analyses at 3-month, 1-year, and 5-year for patient and (non-)death-censored graft survival...
September 2018: Transplantation Direct
Mohamed Abdulkadir Hassan-Kadle, Mugtaba Sulaiman Osman, Pavel Petrovich Ogurtsov
AIM: To provide a clear understanding of viral hepatitis epidemiology and their clinical burdens in Somalia. METHODS: A systematic review and meta-analysis was conducted as Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search of published studies on viral hepatitis was performed from 1977-2016 in PubMed, Google Scholar, Science Direct, World Health Organization African Index Medicus and the Africa Journals Online databases, as well as on the Ministry of Health website...
September 14, 2018: World Journal of Gastroenterology: WJG
Nicholas Wettersten, Hao Tran, Kristin Mekeel, Victor Pretorius, Eric Adler, Saima Aslam
Every year the number of patients waiting for a heart transplant increases faster than the number of available donor organs. Some potential donor organs are from donors with active communicable diseases, including hepatitis C virus (HCV), potentially making donation prohibitive. The advent of direct-acting antiviral agents for HCV has drastically changed the treatment of HCV. Recently, these agents have been used to treat HCV in organ donor recipients who acquired the disease from the donor organ. We report a case of heart-kidney transplantation from an HCV viremic donor to HCV negative recipient with successful treatment and sustained virologic response...
September 17, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Jessica M Ruck, Dorry L Segev
PURPOSE OF REVIEW: Due to the organ shortage, which prevents over 90 000 individuals in the United States from receiving life-saving transplants, the transplant community has begun to critically reevaluate whether organ sources that were previously considered too risky provide a survival benefit to waitlist candidates. RECENT FINDINGS: Organs that many providers were previously unwilling to use for transplantation, including kidneys with a high Kidney Donor Profile Index or from increased risk donors who have risk factors for window period hepatitis C virus (HCV) and HIV infection, have been shown to provide a survival benefit to transplant waitlist candidates compared with remaining on dialysis...
November 2018: Current Opinion in Nephrology and Hypertension
Elizaveta Padalko, Katrien Lagrou, Marie-Luce Delforge, Hilde Jansens, Nadine Ectors, Jean-Paul Pirnay, Johan Klykens, Etienne Sokal, Ludo Muylle, Agnes Libois, Alain Vanderkelen, Gilbert Verbeken, Conny Matthys, Dominique Goossens, Geert Hanssens, Muriel Baltes, Hilde Beele
This paper on the biological tests carried out on serum/plasma samples from donors of human body material (HBM) is the result of a project of the working Group of Superior Health Council of Belgium formed with experts in the field of HBM and infectious serology. Indeed, uncertainty about the interpretation of biological test results currently leads to the sometimes unjustified cancelling of planned donations or the rejection of harvested HBM, whilst more sophisticated diagnostic algorithms would still allow the use of organs or HBM that would otherwise have been rejected...
August 29, 2018: Cell and Tissue Banking
Elizabeth Buganza-Torio, Karen Elizabeth Doucette
With potent nucleos(t)ide analogue (NA) therapy, hepatitis B virus (HBV) is now an uncommon indication for liver transplant (LT) in North America. NA therapy, with or without hepatitis B immunoglobulin, results in low recurrence rates and excellent outcomes after LT. Direct-acting antiviral therapy for hepatitis C virus (HCV), results in cure in most patients, either before or after transplant. There are now descriptions of good clinical outcomes of transplant from HBV and HCV infected donors, as treatments are so effective and well tolerated...
September 2018: Infectious Disease Clinics of North America
Emily D Bethea, Sumeyye Samur, Fasiha Kanwal, Turgay Ayer, Chin Hur, Mark S Roberts, Norah Terrault, Raymond T Chung, Jagpreet Chhatwal
BACKGROUND & AIMS: Guidelines do not recommend transplanting hepatitis C virus (HCV)-infected livers into HCV-uninfected recipients. Direct-acting antivirals (DAAs) can be used to treat donor-derived HCV infection. However the added cost of DAA therapy is a barrier. We evaluated the cost effectiveness of transplanting HCV-positive livers into HCV-negative patients with preemptive DAA therapy. METHODS: A previously validated Markov-based mathematical model was adapted to simulate a virtual trial of HCV-negative patients on the liver transplant waitlist...
August 20, 2018: Clinical Gastroenterology and Hepatology
Snehal R Patel, Shivank Madan, Omar Saeed, Daniel B Sims, J Julia Shin, Cecilia Nucci, Edward Borukhov, Doctor Y Goldstein, William Jakobleff, Stephen Forest, Sasa Vukelic, Sandhya Murthy, John Reinus, Yoram Puius, Daniel J Goldstein, Ulrich P Jorde
BACKGROUND: Hepatitis C (HCV) donors are rarely used for cardiac transplantation due to historically poor outcomes. In 2015, nucleic acid testing (NAT) for viral load was added to the routine work-up of organ donors, allowing for the distinction between subjects who remain viremic (HCV Ab+ /NAT+ ) and those who have cleared HCV and are no longer viremic (HCV Ab+ /NAT- ). The American Society of Transplantation recently recommended that HCV Ab+ /NAT- donors be considered non-infectious and safe for transplantation...
August 17, 2018: Journal of Heart and Lung Transplantation
David S Goldberg, Cameron R Wolfe
No abstract text is available yet for this article.
October 2018: American Journal of Transplantation
Ichiro Tamaki, Koichiro Hata, Yusuke Okamura, Yermek Nigmet, Hirofumi Hirao, Toyonari Kubota, Osamu Inamoto, Jiro Kusakabe, Toru Goto, Tetsuya Tajima, Junichi Yoshikawa, Hirokazu Tanaka, Tatsuaki Tsuruyama, Rene H Tolba, Shinji Uemoto
Cold storage (CS) remains the gold standard for organ preservation worldwide, though it is inevitably associated with cold-ischemia/warm-reperfusion injury (IRI). Molecular hydrogen (H2 ) is well-known to have anti-oxidative properties, however, its unfavorable features, i.e. inflammability, low solubility, and high tissue/substance permeability, have hampered its clinical application. To overcome such obstacles, we developed a novel reconditioning method for donor organs, named HyFACS (hydrogen flush after cold storage), just an end-ischemic H2 -flush directly to donor organs ex vivo, and herein report its therapeutic impact against hepatic IRI...
August 18, 2018: Liver Transplantation
Peter P Reese, Peter L Abt, Emily A Blumberg, Vivianna M Van Deerlin, Roy D Bloom, Vishnu S Potluri, Matthew Levine, Paige Porrett, Deirdre Sawinski, Susanna M Nazarian, Ali Naji, Richard Hasz, Lawrence Suplee, Jennifer Trofe-Clark, Anna Sicilia, Maureen McCauley, Caren Gentile, Jennifer Smith, Bijan A Niknam, Melissa Bleicher, K Rajender Reddy, David S Goldberg
Background: Organs from hepatitis C virus (HCV)-infected deceased donors are often discarded. Preliminary data from 2 small trials, including THINKER-1 (Transplanting Hepatitis C kidneys Into Negative KidnEy Recipients), suggested that HCV-infected kidneys could be safely transplanted into HCV-negative patients. However, intermediate-term data on quality of life and renal function are needed to counsel patients about risk. Objective: To describe 12-month HCV treatment outcomes, estimated glomerular filtration rate (eGFR), and quality of life for the 10 kidney recipients in THINKER-1 and 6-month data on 10 additional recipients...
September 4, 2018: Annals of Internal Medicine
Daniel R Kaul, Susan M Tlusty, Marian G Michaels, Ajit P Limaye, Cameron R Wolfe
The opioid epidemic has resulted in a potential increase in donors in the testing window period for hepatitis C virus (HCV). We analyzed HCV reports to the Disease Transmission Advisory Committee (DTAC) between 2008 and 2016 to estimate the risk of HCV transmission. In 15 of 95 (16%) reports, at least one recipient developed proven/probable donor-derived HCV resulting in 32 infected recipients. Seven transmissions occurred during the nucleic acid testing (NAT) window period; four occurred during serological window period...
October 2018: Clinical Transplantation
Gaurav Gupta, Yiran Zhang, Norman V Carroll, Richard K Sterling
Pilot studies suggest that transplanting hepatitis C virus (HCV)-positive donor (D+) kidneys into HCV-negative renal transplant (RT) recipients (R-), then treating HCV with direct-acting antivirals (DAA) is clinically feasible. To determine whether this is a cost-effective approach, a decision tree model was developed to analyze costs and effectiveness over a 5-year time frame between 2 choices: RT using a D+/R- strategy compared to continuing dialysis and waiting for a HCV-negative donor (D-/R-). The strategy of accepting a HCV+ organ then treating HCV was slightly more effective and substantially less expensive and resulted in an expected 4...
October 2018: American Journal of Transplantation
Yuri L Boteon, Richard W Laing, Andrea Schlegel, Loraine Wallace, Amanda Smith, Joseph Attard, Ricky H Bhogal, Desley Ah Neil, Stefan Hübscher, M Thamara Pr Perera, Darius F Mirza, Simon C Afford, Hynek Mergental
BACKGROUND: Hypothermic oxygenated perfusion and normothermic perfusion are seen as distinct techniques of ex-situ machine perfusion of the liver. We aimed to demonstrate the feasibility of combining both techniques and whether it would improve functional parameters of donor livers into transplant standards. METHODS: Ten discarded human donor livers had either 6 hours of normothermic perfusion (n=5) or 2 hours of hypothermic oxygenated perfusion followed by 4 hours of normothermic perfusion (n=5)...
July 30, 2018: Liver Transplantation
J Pliszczyński, K Jasztal, A Jóźwik, M Kosieradzki, R Danielewicz, P Małkowski, J Czerwiński
Kidney transplant (KTx) is the best method of renal insufficiency treatment. In dialyzed patients, mortality rises with the time on dialysis. There is a continuing shortage of organs for transplantation, hence a propensity to expand the donor pool with expanded-criteria donors, anti-hepatitis C virus-positive included. In the above case a transmission of hepatitis C virus (HCV) genotype to recipient is present. It has been proven that contamination with more than 1 HCV genotype did not worsen KTx outcomes. There are 2...
July 2018: Transplantation Proceedings
Claudio Velati, Luisa Romanò, Vanessa Piccinini, Giuseppe Marano, Liviana Catalano, Simonetta Pupella, Giuseppina Facco, Ilaria Pati, Maria Elena Tosti, Stefania Vaglio, Giuliano Grazzini, Alessandro Zanetti, Giancarlo M Liumbruno
BACKGROUND: In Italy nucleic acid testing (NAT) became mandatory for hepatitis C virus (HCV) in 2002 and for human immunodeficiency virus (HIV) and hepatitis B virus in 2008. The aim of this study was to monitor the incidence and prevalence of HIV and HCV infections in Italian blood donors and the current residual risk of these infections after the introduction of NAT. MATERIALS AND METHODS: The Italian national blood surveillance system includes data from tests used to screen for transfusion-transmissible infections...
September 2018: Blood Transfusion, Trasfusione del Sangue
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