Table 3.

Overview of risks of accepting an HCV viremic donor

Acute HCV infection risk

Acute hepatitis

Fibrosing cholestatic hepatitis

Chronic HCV infection

Chronic liver disease

Cirrhosis/End-stage liver disease, liver cancer, death

Extrahepatic manifestations - mixed cryoglobulinemia, glomerulonephritis, neurocognitive changes, lichen planus

Risk of DAA failure

Virologic failure, development of resistance, second-line treatment options

Incorrect genotyping test*

Risk of HCV transmission to household or sexual partners**

Side effects of particularly DAA regimen selected

^*Only relevant if a pan-genotypic DAA regimen was used

^**This is extremely low; however, we recommend avoiding blood contact and using barrier protection for sexual encounters until sustained virologic response 12 weeks after treatment. Abbreviations: HCV = hepatitis C virus, DAAs = direct-acting antivirals