Another issue that has emerged is the use of donor organs, including livers, kidneys, hearts and lungs, from HCV-positive donors, which were previously used only in HCV viraemic recipients. Now, and with appropriate consent, HCV viraemic donor livers have been used in HCV-negative recipients in Australia. This strategy has the potential to increase donor organ availability and reduce waiting list times. International experience has shown that HCV-positive donor kidneys, hearts and lungs can also be successfully transplanted into HCV-negative recipients.
When an anti-HCV-positive/HCV RNA-positive donor is used, HCV infection will be transmitted and should be treated with DAAs in the early post-transplant period. Deferring antiviral therapy increases the risk of symptomatic acute hepatitis C infection; cases of FCH have been reported. This is an evolving and complicated area. The optimal timing and duration of DAA therapy in this setting continue to be evaluated.
Transmission from anti-HCV-positive/HCV RNA-negative donors is extremely rare and, where reported, probably reflects acute infection in high-risk donor..