scholarly journals Let's Make a Deal: Shortening the Solid Organ Transplant Waiting Time in Exchange for Transmitting and Treating Hepatitis C Infection in the Era of Safe and Effective Directly Acting Antivirals

2017 ◽  
Vol 66 (2) ◽  
pp. 293-295 ◽  
Author(s):  
Ethan M Weinberg ◽  
K Rajender Reddy
Keyword(s):  
Hepatitis C ◽  
Waiting Time ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Hepatitis C Infection

Clinical pharmacy programmatic perspectives on use of direct-acting antivirals for acquired hepatitis C infection in solid organ transplant recipients

2020 ◽  
Vol 77 (14) ◽  
pp. 1149-1152
Author(s):  
Lana Crona ◽  
Holly Berry ◽  
Jennifer Byrns ◽  
Udobi Campbell
Keyword(s):  
Hepatitis C ◽  
Pharmaceutical Care ◽  
Solid Organ Transplantation ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Hepatitis C Infection ◽  
Financial Barriers ◽  
Clinical Pharmacists ◽  
Specialty Pharmacy

Abstract Purpose An institutional workflow developed by clinical pharmacists for initiation of directing-acting antiviral (DAA) therapy for patients who receive solid organ transplants from hepatitis C (HCV)–positive donors is described; programmatic challenges in providing pharmaceutical care to these patients are reviewed. Summary In recent years the introduction of new oral DAAs, coupled with faster screening of donor organs for HCV infection through use of a nucleic acid test (NAT), has facilitated transplants of organs from HCV-seropositive donors to HCV-seronegative recipients. The solid organ transplant program of a North Carolina health system began performing such transplants in December 2017. In the pharmacist-developed workflow, patients are initiated on DAA therapy in the outpatient clinic setting, and clinic pharmacists are consulted regarding drug selection. Prescriptions for DAA therapy are sent to an on-site specialty pharmacy, where pharmacists and pharmacy technicians work to obtain prior authorization and, if necessary, payment assistance through manufacturer-sponsored programs. The medical team is notified at the time of patient approval to begin treatment. Pharmacists provide counseling at the time of DAA therapy initiation and follow up with patients every 2 weeks to confirm adherence. As of June 2019, about 100 transplants of HCV NAT–positive organs had been performed (approximately 50% were kidney transplants; 15%, lung transplants; 20%, heart transplants; and 15%, liver transplants). Many challenges are encountered in the process of providing pharmaceutical care to this patient population, including challenges in patient selection and counseling, overcoming financial barriers and insurance restrictions, and coordinating with an internal specialty pharmacy to ensure timely delivery of medication to patients. Conclusion Within a solid organ transplantation program, clinical pharmacists and other pharmacy personnel can play vital roles in ensuring safe and effective DAA therapy for recipients of transplanted HCV NAT–positive organs.

SEROLOGIC RESPONSES TO HEPATITIS C VIRUS IN SOLID ORGAN TRANSPLANT RECIPIENTS1

1997 ◽  
Vol 64 (12) ◽  
pp. 1775-1780 ◽  
Author(s):  
Jutta K. Preiksaitis ◽  
Sandra M. Cockfield ◽  
Jayne M. Fenton ◽  
N. Ilene Burton ◽  
Linda W.-L. Chui
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ

scholarly journals Hepatitis C virus infection and risk of posttransplantation lymphoproliferative disorder among solid organ transplant recipients

Blood ◽  
2007 ◽  
Vol 110 (13) ◽  
pp. 4599-4605 ◽  
Author(s):  
Lindsay M. Morton ◽  
Ola Landgren ◽  
Nilanjan Chatterjee ◽  
David Castenson ◽  
Ruth Parsons ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Lymphoproliferative Disorder ◽  
Organ Transplant ◽  
The United States ◽  
Solid Organ Transplant ◽  
Hcv Infection ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Posttransplantation Lymphoproliferative Disorder

Posttransplantation lymphoproliferative disorder (PTLD) is a serious complication of solid organ transplantation. Hepatitis C virus (HCV) infection has been linked to increased risk of lymphoma among immunocompetent individuals. We therefore investigated the association between HCV infection and PTLD in a retrospective cohort study of all individuals in the United States who received their first solid organ transplant from 1994 to 2005 (N = 210 763) using Scientific Registry of Transplant Recipients data. During follow-up, 1630 patients with PTLD were diagnosed. HCV prevalence at transplantation was 11.3%. HCV infection did not increase PTLD risk in the total cohort (Cox regression model, hazard ratio [HR] = 0.84; 95% confidence interval [CI] 0.68-1.05), even after adjustment for type of organ transplanted, indication for transplantation, degree of HLA mismatch, donor type, or use of immunosuppression medications. Additional analyses also revealed no association by PTLD subtype (defined by site, pathology, cell type, and tumor Epstein-Barr virus [EBV] status). HCV infection did increase PTLD risk among the 2.8% of patients (N = 5959) who were not reported to have received immunosuppression maintenance medications prior to hospital discharge (HR = 3.09; 95% CI, 1.14-8.42; P interaction = .007). Our findings suggest that HCV is not a major risk factor for PTLD, which is consistent with the model in which an intact immune system is necessary for development of HCV-related lymphoproliferation.

Sign in / Sign up

Export Citation Format

Share Document