20.500.12556/DiRROS-24108 Prophylactic treatment of hepatitis C virus infection after kidney transplantation with the combination of glecaprevir/pibrentasvir and sofosbuvir in a highly sensitized hepatitis c virus-negative recipient a case report and review of the literature Background: Since the discovery of successful direct-acting antiviral (DAA) treatment, kidneys from hepatitis C virus (HCV) RNA-positive donors represent a new opportunity to expand the organ donor pool for HCV-negative recipients. Case presentation: In this paper, we describe a unique case of transplantation of an HCV genotype 3a-infected kidney into an HCV-negative recipient who was highly sensitized, with a virtual panel-reactive antibody level of 99.96%. Prior to the kidney transplantation, the recipient received DAA treatment with glecaprevir/pibrentasvir as a viable prophylactic strategy. Post-transplant, the recipient received a triple-combination DAA regimen with glecaprevir/pibrentasvir/sofosbuvir, which continued for 12 weeks. Subsequently, viral load was undetectable at 12 and 24 weeks after treatment, with no significant adverse events associated with DAA therapy. A 12-month post-transplantation biopsy revealed mixed rejection requiring treatment. The 19-month follow-up showed a favorable outcome regarding the function of the kidney allograft and the recipient’s quality of life. HCV-positive transplantation allowed our recipient to receive a kidney from an immunologically compatible donor without donor-specific antibodies and the need for desensitization strategies. Conclusions: Each transplant center should decide on the selection of candidates for kidney transplantation from HCV RNA-positive donors to HCV-negative recipients, the availability and choice of DAA treatment, and post-transplant follow-up. Our case emphasizes the need for early DAA treatment based on viral load and HCV genotyping, as well as for careful post-transplant surveillance including protocol biopsies. kidney transplantation HCV RNA direct-acting antiviral (DAA) glecaprevir/pibrentasvir sensitization case report true false true Angleški jezik Ni določen Neznano 2025-11-12 14:27:19 2025-11-12 14:27:19 2025-11-13 08:22:04 0000-00-00 00:00:00 2025 0 0 Nasl. z nasl. zaslona; Opis vira z dne 19. 5. 2025; 14 str. issue 2, [article no.] 472 Vol. 13 Feb. 2025 0000-00-00 Zaloznikova Objavljeno apc 0000-00-00 0000-00-00 0000-00-00 616.9 2227-9059 10.3390/biomedicines13020472 236386307 RAZ_Belcic_Mikic_Tanja_2025.pdf RAZ_Belcic_Mikic_Tanja_2025.pdf 1 E11CD5EA39B3E6630EDBA535D3E07F2F 4f7c2c3919adcf390eeac53daa5b6b7904e1e8d2906c27b47d846040339fb645 290bc29c-bfcc-11f0-94a7-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=35864 https://www.mdpi.com/2227-9059/13/2/472 1 5195e567-bfcb-11f0-94a7-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=35863 Univerzitetni klinični center Ljubljana 0 0 0