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It is a Hepacivirus of the Flaviviridae family, which has 7 genotypes.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> Its transmission is parenteral, therefore its transmission through transplanted organs has been well documented and it causes acute and chronic hepatitis.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> Given this risk, transplant from donors with antibodies against HCV has been totally contraindicated in noninfected recipients. It is estimated that more than 500 high quality kidney grafts are discarded annually in the USA for this reason.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> In 2016 we did not transplanted 15 kidneys for this reason.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">.</span> A number of organs could be transplanted to recipients infected with HCV.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> The efficacy of direct-acting antivirals eliminated HCV patients from the waiting lists<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> making possible the use these organs, in a society clearly need them.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">At present we have tools to change this panorama that have been clearly stated in the Hepatitis C Consensus Conference of the American Society of Transplantion.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The risk of HCV transmission must be defined; there is a clear distinction between donor carrying antibodies, not necessarily infectious, and the patient with viraemia that is infective. To carry out this separation, we use the Xpert® HCV Viral Load test with the Cepheid GeneXpert® system (distributed by Werfen), available in our hospital, that quantifies the viral load in 1<span class="elsevierStyleHsp" style=""></span>h which allows the quick identification of the infective donor.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The efficacy, safety and tolerability of direct antivirals make feasible the transplantation of viraemic donors in seronegative recipients. Even more now with the current commercialization of the compounds glecaprevir and pibrentasvir effective against all genotypes, so there is no need to identify the genotype of the donor and are not contraindicated in renal failure, which allows its use in the peritransplant period.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Having these tools and the successful experiences by Durand et al.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> and Goldberg et al.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> this year, we requested an ethical evaluation to implement an action protocol (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>) to the bioethics committee of our hospital, which gave its approval on July 18, 2017 and stressed the importance of explaining to the recipient the procedure for the subsequent signing of an informed consent.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">In the application of the protocol of action (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>), we transplanted 2 seronegative male HCV recipients of 45 and 58 years with grafts from a 40-year-old female donor and a 57-year-old male both seropositive, but with negative viral load, for what we apply the action 1. The patients today are carriers of a functioning graft and the viral load in them has been repeatedly negative.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Our initial experience, endorsed by other teams, should encourage the extensive, albeit meticulous, use of this type of donors and lead us to the conclusion that HCV, the enemy to beat, is very likely beaten.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Franco A, Balibrea N, Gimeno A, Merino E, Lopez MI, Santiago C, et al. Trasplantar receptores hepatitis C negativos con riñones de donantes seropositivos. ¿Por qué no? Nefrologia. 2018. <a class="elsevierStyleInterRef" target="_blank" id="intr0005" href="https://doi.org/10.1016/j.nefro.2018.04.005">https://doi.org/10.1016/j.nefro.2018.04.005</a></p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Donor to include:</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Carriers of HCV antibodies</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">No drug addiction or institutionalization</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Rapid assessment of viral load</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Absent viral load: acting group 1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Viral load present: action group 2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; 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entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Action to follow:</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Action 1: considered non-infective</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Standard renal TX \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Biweekly viral load quantification/3 months \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Positive \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Glecaprevir 300<span class="elsevierStyleHsp" style=""></span>mg \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Pibrentasvir 120<span class="elsevierStyleHsp" style=""></span>mg/12 weeks \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Negative: no treatment \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Action 2: considered infective</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Pre-tx and post-tx</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">or Glecaprevir 300</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">mg</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">or Pibrentasvir 120</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">mg/12 weeks</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1921430.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Action protocol.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[accessed 1 Dec 2017] Available in: http://jvi.asm.org/cgi/doi/10.1128/JVI. 00526-10" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ultrastructural and biophysical characterization of hepatitis C virus particles produced in cell culture" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. 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Year/Month | Html | Total | |
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2024 November | 4 | 15 | 19 |
2024 October | 24 | 30 | 54 |
2024 September | 40 | 28 | 68 |
2024 August | 66 | 67 | 133 |
2024 July | 32 | 24 | 56 |
2024 June | 38 | 31 | 69 |
2024 May | 30 | 38 | 68 |
2024 April | 49 | 26 | 75 |
2024 March | 31 | 28 | 59 |
2024 February | 22 | 27 | 49 |
2024 January | 21 | 23 | 44 |
2023 December | 19 | 21 | 40 |
2023 November | 33 | 32 | 65 |
2023 October | 39 | 29 | 68 |
2023 September | 32 | 26 | 58 |
2023 August | 24 | 24 | 48 |
2023 July | 26 | 22 | 48 |
2023 June | 46 | 20 | 66 |
2023 May | 55 | 27 | 82 |
2023 April | 36 | 12 | 48 |
2023 March | 57 | 26 | 83 |
2023 February | 34 | 21 | 55 |
2023 January | 37 | 28 | 65 |
2022 December | 52 | 27 | 79 |
2022 November | 38 | 38 | 76 |
2022 October | 70 | 42 | 112 |
2022 September | 34 | 49 | 83 |
2022 August | 25 | 51 | 76 |
2022 July | 36 | 55 | 91 |
2022 June | 31 | 47 | 78 |
2022 May | 55 | 30 | 85 |
2022 April | 36 | 48 | 84 |
2022 March | 39 | 52 | 91 |
2022 February | 67 | 42 | 109 |
2022 January | 49 | 44 | 93 |
2021 December | 71 | 45 | 116 |
2021 November | 26 | 39 | 65 |
2021 October | 29 | 45 | 74 |
2021 September | 26 | 45 | 71 |
2021 August | 27 | 39 | 66 |
2021 July | 67 | 40 | 107 |
2021 June | 26 | 32 | 58 |
2021 May | 35 | 45 | 80 |
2021 April | 61 | 86 | 147 |
2021 March | 51 | 50 | 101 |
2021 February | 37 | 43 | 80 |
2021 January | 32 | 26 | 58 |
2020 December | 22 | 17 | 39 |
2020 November | 18 | 19 | 37 |
2020 October | 21 | 19 | 40 |
2020 September | 19 | 17 | 36 |
2020 August | 22 | 11 | 33 |
2020 July | 19 | 16 | 35 |
2020 June | 15 | 13 | 28 |
2020 May | 15 | 15 | 30 |
2020 April | 22 | 19 | 41 |
2020 March | 13 | 15 | 28 |
2020 February | 22 | 16 | 38 |
2020 January | 33 | 34 | 67 |
2019 December | 28 | 36 | 64 |
2019 November | 22 | 23 | 45 |
2019 October | 26 | 15 | 41 |
2019 September | 20 | 20 | 40 |
2019 August | 20 | 20 | 40 |
2019 July | 20 | 23 | 43 |
2019 June | 22 | 18 | 40 |
2019 May | 27 | 26 | 53 |
2019 April | 38 | 43 | 81 |
2019 March | 34 | 29 | 63 |
2019 February | 19 | 20 | 39 |
2019 January | 31 | 36 | 67 |
2018 December | 75 | 51 | 126 |