Direct Acting Antiviral Therapy in Donor HCV-positive to Recipient HCV-negative Kidney Transplant

Exclusion Criteria

• •AB blood type
• •BMI \> 35
• •Any liver disease in recipient
• •Pregnant or nursing (lactating) women
• •Known allergy or intolerance to tacrolimus that would require administration of cyclosporine rather than tacrolimus given the known drug-drug interaction between cyclosporine and Mavyret
• •Cardiomyopathy (LV ejection fraction \< 50%)
• •Albumin \< 3g/dl or platelet count \< 75 x 103/mL
• •Positive donor specific antibodies or positive cross match deemed to be clinically relevant and increasing risk of rejection per the transplant surgeon or nephrologist
• •Positive donor specific antibodies or positive cross match deemed to be clinically relevant and increasing risk of rejection per the transplant surgeon or nephrologist
• •HCV RNA positive
• •Hepatitis B surface antigen positive
• •Any known liver disease or elevated liver transaminases
• •Patients with primary focal segmental glomerulosclerosis (FSGS), FSGS recurring after previous transplant, or disease process with increased risk of causing early graft failure as assessed by the transplant nephrologist and/or the investigator team
• •Any contra-indication to kidney transplantation per MGH center protocol
• •Patients on the following medications who cannot stop therapy: carbamazepine, rifampin, St. John's wort, and ethinyl estradiol-containing oral contraceptives.