NYMC Faculty Publications

Risk of Hepatitis C Transmission After Liver Transplantation From Hepatitis C Nonviremic, Antibody-Positive Donors Into Nonviremic Recipients in the Era of Mandated Testing

DOI

10.1097/TP.0000000000005497

Journal Title

Transplantation

First Page

1871

Last Page

1876

Document Type

Article

Publication Date

12-1-2025

Department

Surgery

Second Department

Medicine

Disciplines

Medicine and Health Sciences

Abstract

Background. – Starting in March 2021, the Organ Procurement and Transplantation Network (OPTN) mandated testing and reporting of hepatitis C virus (HCV), hepatitis B virus, and HIV at 4–8 wk posttransplantation. The aim of this study was to assess the rates of detectable HCV viremia in HCV nucleic acid test (NAT) negative recipients of liver allografts from HCV antibody-positive/NAT-negative (Ab+/NAT–) donors in a nationwide cohort after the institution of the reporting mandate. Methods. – Post–liver transplant (LT) HCV viremia and patient/graft outcomes were compared between 2 groups using the OPTN database: HCV negative LT recipients of donors with HCV Ab+/NAT– and HCV Ab–/NAT– between March 2021 and March 2023. Results. – Among 7447 recipients (Ab+/NAT– N = 380 and Ab–/NAT– N = 7067), 5 (1.5%) of Ab+/NAT– LT recipients and 5 (0.09%) of Ab–/NAT– LT recipients reported a positive HCV NAT result during the median follow-up period of 182 (175–199) d post-LT. In this early period of mandated reporting, HCV NAT results at 6 mo posttransplant were available for 85.3% of the Ab+/NAT– group and 77.1% of the Ab–/NAT– group. Overall and graft survival were comparable among the 2 groups at 6 and 12 mo post-LT. Conclusions. – After the OPTN mandate of HCV testing post-LT starting March 2021, the rate of positive HCV NAT results was 1.5% in HCV NAT– recipients of liver allografts from HCV Ab+/NAT– donors. Improved compliance with the mandated testing can help in the early detection of HCV transmission among LT recipients in this cohort and may help prevent associated post-LT complications.

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