| Title: | 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 |
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| Authors: | ID Belčič Mikič, Tanja (Author)
ID Sterle, Igor (Author)
ID Matičič, Mojca (Author)
ID Arnol, Miha (Author) |
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| Files: |  PDF - Presentation file, download (785,45 KB)
MD5: E11CD5EA39B3E6630EDBA535D3E07F2F
 URL - Source URL, visit https://www.mdpi.com/2227-9059/13/2/472
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| Language: | English |
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| Typology: | 1.03 - Other scientific articles |
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| Organization: |  UKC LJ - Ljubljana University Medical Centre
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| Abstract: | 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. |
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| Keywords: | kidney transplantation, HCV RNA, direct-acting antiviral (DAA), glecaprevir/pibrentasvir, sensitization, case report |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Year of publishing: | 2025 |
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| Number of pages: | 14 str. |
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| Numbering: | Vol. 13, issue 2, [article no.] 472 |
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| PID: | 20.500.12556/DiRROS-24108  |
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| UDC: | 616.9 |
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| ISSN on article: | 2227-9059 |
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| DOI: | 10.3390/biomedicines13020472 |
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| COBISS.SI-ID: | 236386307 |
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| Note: | Nasl. z nasl. zaslona;
Opis vira z dne 19. 5. 2025;
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| Publication date in DiRROS: | 12.11.2025 |
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| Views: | 153 |
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| Downloads: | 66 |
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