---
title: "4-Week Sofosbuvir/Velpatasvir Prophylaxis After HCV‑Viremic Donor Kidney Transplantation: VA Cohor"
id: "pubmed-42530567"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42530567"
content_type: "clinical_feed_article"
specialty: "Infectious Disease"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42530567/"
doi: "10.1111/ctr.70629"
published_at: "2026-08-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# 4-Week Sofosbuvir/Velpatasvir Prophylaxis After HCV‑Viremic Donor Kidney Transplantation: VA Cohor
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42530567
- **Specialty:** [Infectious Disease](https://medichelpline.com/clinical-feed/infectious-disease.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42530567/)
- **DOI:** [10.1111/ctr.70629](https://doi.org/10.1111%2Fctr.70629)
- **Published At:** 2026-08-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This retrospective VA study evaluated outcomes after a 28-day **sofosbuvir/velpatasvir (SOF/VEL)** prophylaxis protocol in 50 **HCV** seronegative adults who received kidneys from HCV NAT‑positive deceased donors (Sept 2017–Mar 2025). - Primary endpoint was sustained virologic response 12 weeks after prophylaxis completion (**SVR12**). Initial SVR12 was achieved in 46 of 50 patients (92%). - Four patients (8%) failed the 4‑week prophylaxis and required full HCV treatment; after treatment all patients achieved SVR, yielding a 100% overall SVR rate. - Secondary outcomes at 1 year: delayed graft function (DGF) 16%, biopsy‑proven acute rejection (BPAR) 12%, CMV viremia 18%, BK viremia 16%, mean eGFR 57.7 ± 18.7 mL/min/1.73 m2, and one‑year all‑cause mortality 2% (1/50), unrelated to HCV or DAA. - No adverse events were attributed to the **DAA** regimen. Two patients had SOF/VEL extended to 12 weeks because of transient viremia and were counted among initial SVR12 successes. - Older age and higher Estimated Post Transplant Survival (EPTS) scores were associated with prophylaxis failure: age 72.3 ± 4.0 vs 62.0 ± 11.0 years (p = 0.030); EPTS 86.5 ± 19.1 vs 61.8 ± 29.3 (p = 0.041). - Study population characteristics: mean age 62.8 ± 10.9 years, 92% male, mean EPTS 63.7 ± 29.2, mean KDPI 59.8 ± 19.6. - Authors conclude that a 4‑week SOF/VEL prophylaxis strategy combined with HCV RNA surveillance and prompt treatment is safe and effective in this veteran cohort. Details on protocol specifics, monitoring cadence, and exact retreatment regimens were not reported in the abstract.
## Clinical Analysis & Structured Key Points
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more resources ](https://pubmed.ncbi.nlm.nih.gov/42530567/#linkout) Title & authors Abstract Conflict of interest statement Figures Similar articles References MeSH terms Substances Related information LinkOut - more resources Clin Transplant Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Clin+Transplant%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Clin+Transplant%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42530567/) . 2026 Aug;40(8):e70629. doi: 10.1111/ctr.70629. # Outcomes After 4-Week Course of Sofosbuvir/Velpatasvir Therapy in Hepatitis C Seronegative Recipients of Kidneys From Hepatitis C Viremic Deceased Donors [Basheer Ahamad Kummangal](https://pubmed.ncbi.nlm.nih.gov/?term=Kummangal+BA&cauthor_id=42530567)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#full-view-affiliation-1 "Division of Nephrology and Hypertension, VA Portland Health Care System, Portland, Oregon, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#full-view-affiliation-2 "Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, Oregon, USA."), [Madelaine Hack](https://pubmed.ncbi.nlm.nih.gov/?term=Hack+M&cauthor_id=42530567)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#full-view-affiliation-3 "Division of Abdominal Organ Transplantation, VA Portland Health Care System, Portland, Oregon, USA.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#full-view-affiliation-4 "Division of Abdominal Organ Transplantation, Oregon Health & Science University, Portland, Oregon, USA."), [Sri Abirami Selvam](https://pubmed.ncbi.nlm.nih.gov/?term=Selvam+SA&cauthor_id=42530567)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#full-view-affiliation-1 "Division of Nephrology and Hypertension, VA Portland Health Care System, Portland, Oregon, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#full-view-affiliation-2 "Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, Oregon, USA."), [Christopher Connelly](https://pubmed.ncbi.nlm.nih.gov/?term=Connelly+C&cauthor_id=42530567)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#full-view-affiliation-3 "Division of Abdominal Organ Transplantation, VA Portland Health Care System, Portland, Oregon, USA.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#full-view-affiliation-4 "Division of Abdominal Organ Transplantation, Oregon Health & Science University, Portland, Oregon, USA."), [Justin Smith](https://pubmed.ncbi.nlm.nih.gov/?term=Smith+J&cauthor_id=42530567)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#full-view-affiliation-1 "Division of Nephrology and Hypertension, VA Portland Health Care System, Portland, Oregon, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#full-view-affiliation-2 "Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, Oregon, USA."), [Jay Pandav](https://pubmed.ncbi.nlm.nih.gov/?term=Pandav+J&cauthor_id=42530567)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#full-view-affiliation-1 "Division of Nephrology and Hypertension, VA Portland Health Care System, Portland, Oregon, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#full-view-affiliation-2 "Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, Oregon, USA."), [Angelo de Mattos](https://pubmed.ncbi.nlm.nih.gov/?term=Mattos+A&cauthor_id=42530567)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#full-view-affiliation-1 "Division of Nephrology and Hypertension, VA Portland Health Care System, Portland, Oregon, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#full-view-affiliation-2 "Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, Oregon, USA."), [Long Do](https://pubmed.ncbi.nlm.nih.gov/?term=Do+L&cauthor_id=42530567)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#full-view-affiliation-5 "Department of Pharmacy Services, VA Portland Health Care System, Portland, Oregon, USA."), [Aaron Ziolko](https://pubmed.ncbi.nlm.nih.gov/?term=Ziolko+A&cauthor_id=42530567)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#full-view-affiliation-5 "Department of Pharmacy Services, VA Portland Health Care System, Portland, Oregon, USA."), [Domenica McKenna](https://pubmed.ncbi.nlm.nih.gov/?term=McKenna+D&cauthor_id=42530567)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#full-view-affiliation-5 "Department of Pharmacy Services, VA Portland Health Care System, Portland, Oregon, USA."), [Shehzad Rehman](https://pubmed.ncbi.nlm.nih.gov/?term=Rehman+S&cauthor_id=42530567)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#full-view-affiliation-1 "Division of Nephrology and Hypertension, VA Portland Health Care System, Portland, Oregon, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#full-view-affiliation-2 "Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, Oregon, USA.") Affiliations Expand ### Affiliations * 1 Division of Nephrology and Hypertension, VA Portland Health Care System, Portland, Oregon, USA. * 2 Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, Oregon, USA. * 3 Division of Abdominal Organ Transplantation, VA Portland Health Care System, Portland, Oregon, USA. * 4 Division of Abdominal Organ Transplantation, Oregon Health & Science University, Portland, Oregon, USA. * 5 Department of Pharmacy Services, VA Portland Health Care System, Portland, Oregon, USA. * PMID: **42530567** * PMCID: [ PMC13422655 ](https://pmc.ncbi.nlm.nih.gov/articles/PMC13422655/) * DOI: [ 10.1111/ctr.70629 ](https://doi.org/10.1111/ctr.70629) Item in Clipboard # Outcomes After 4-Week Course of Sofosbuvir/Velpatasvir Therapy in Hepatitis C Seronegative Recipients of Kidneys From Hepatitis C Viremic Deceased Donors Basheer Ahamad Kummangal et al. Clin Transplant. 2026 Aug. Show details Display options Display options Format Abstract PubMed PMID Clin Transplant Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Clin+Transplant%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Clin+Transplant%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42530567/) . 2026 Aug;40(8):e70629. doi: 10.1111/ctr.70629. ### Authors [Basheer Ahamad Kummangal](https://pubmed.ncbi.nlm.nih.gov/?term=Kummangal+BA&cauthor_id=42530567)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#short-view-affiliation-1 "Division of Nephrology and Hypertension, VA Portland Health Care System, Portland, Oregon, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#short-view-affiliation-2 "Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, Oregon, USA."), [Madelaine Hack](https://pubmed.ncbi.nlm.nih.gov/?term=Hack+M&cauthor_id=42530567)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#short-view-affiliation-3 "Division of Abdominal Organ Transplantation, VA Portland Health Care System, Portland, Oregon, USA.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#short-view-affiliation-4 "Division of Abdominal Organ Transplantation, Oregon Health & Science University, Portland, Oregon, USA."), [Sri Abirami Selvam](https://pubmed.ncbi.nlm.nih.gov/?term=Selvam+SA&cauthor_id=42530567)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#short-view-affiliation-1 "Division of Nephrology and Hypertension, VA Portland Health Care System, Portland, Oregon, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#short-view-affiliation-2 "Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, Oregon, USA."), [Christopher Connelly](https://pubmed.ncbi.nlm.nih.gov/?term=Connelly+C&cauthor_id=42530567)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#short-view-affiliation-3 "Division of Abdominal Organ Transplantation, VA Portland Health Care System, Portland, Oregon, USA.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#short-view-affiliation-4 "Division of Abdominal Organ Transplantation, Oregon Health & Science University, Portland, Oregon, USA."), [Justin Smith](https://pubmed.ncbi.nlm.nih.gov/?term=Smith+J&cauthor_id=42530567)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#short-view-affiliation-1 "Division of Nephrology and Hypertension, VA Portland Health Care System, Portland, Oregon, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#short-view-affiliation-2 "Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, Oregon, USA."), [Jay Pandav](https://pubmed.ncbi.nlm.nih.gov/?term=Pandav+J&cauthor_id=42530567)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#short-view-affiliation-1 "Division of Nephrology and Hypertension, VA Portland Health Care System, Portland, Oregon, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#short-view-affiliation-2 "Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, Oregon, USA."), [Angelo de Mattos](https://pubmed.ncbi.nlm.nih.gov/?term=Mattos+A&cauthor_id=42530567)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#short-view-affiliation-1 "Division of Nephrology and Hypertension, VA Portland Health Care System, Portland, Oregon, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#short-view-affiliation-2 "Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, Oregon, USA."), [Long Do](https://pubmed.ncbi.nlm.nih.gov/?term=Do+L&cauthor_id=42530567)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#short-view-affiliation-5 "Department of Pharmacy Services, VA Portland Health Care System, Portland, Oregon, USA."), [Aaron Ziolko](https://pubmed.ncbi.nlm.nih.gov/?term=Ziolko+A&cauthor_id=42530567)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#short-view-affiliation-5 "Department of Pharmacy Services, VA Portland Health Care System, Portland, Oregon, USA."), [Domenica McKenna](https://pubmed.ncbi.nlm.nih.gov/?term=McKenna+D&cauthor_id=42530567)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#short-view-affiliation-5 "Department of Pharmacy Services, VA Portland Health Care System, Portland, Oregon, USA."), [Shehzad Rehman](https://pubmed.ncbi.nlm.nih.gov/?term=Rehman+S&cauthor_id=42530567)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#short-view-affiliation-1 "Division of Nephrology and Hypertension, VA Portland Health Care System, Portland, Oregon, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42530567/#short-view-affiliation-2 "Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, Oregon, USA.") ### Affiliations * 1 Division of Nephrology and Hypertension, VA Portland Health Care System, Portland, Oregon, USA. * 2 Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, Oregon, USA. * 3 Division of Abdominal Organ Transplantation, VA Portland Health Care System, Portland, Oregon, USA. * 4 Division of Abdominal Organ Transplantation, Oregon Health & Science University, Portland, Oregon, USA. * 5 Department of Pharmacy Services, VA Portland Health Care System, Portland, Oregon, USA. * PMID: **42530567** * PMCID: [ PMC13422655 ](https://pmc.ncbi.nlm.nih.gov/articles/PMC13422655/) * DOI: [ 10.1111/ctr.70629 ](https://doi.org/10.1111/ctr.70629) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Kidney transplantation from hepatitis C virus (HCV) viremic deceased donors into HCV seronegative recipients helps to expand the donor pool. The optimal duration of direct acting antiviral (DAA) prophylaxis remains undefined. **Methods:** We performed a retrospective review of all HCV seronegative adults who received a kidney transplant from an HCV nucleic acid test (NAT) positive deceased donor at the VA Portland Medical Center between September 2017 and March 2025 and were treated with sofosbuvir/velpatasvir (SOF/VEL) prophylaxis for 28 days postoperatively. The primary outcome was sustained virologic response 12 weeks after completion of prophylaxis (initial SVR12). Secondary outcomes at 1 year included HCV treatment success rate, biopsy proven acute rejection (BPAR), delayed graft function (DGF), eGFR, liver enzyme abnormalities, CMV and BK viremia, adverse events, and all-cause mortality. **Results:** Fifty patients were included. The mean age was 62.8 ± 10.9 years, 92% were male, mean EPTS was 63.7 ± 29.2 and mean KDPI was 59.8 ± 19.6. Initial SVR12 after completion of prophylaxis was achieved in 46/50 (92%), out of which 2 patients had their SOF/VEL prophylaxis extended to 12 weeks because of transient viremia. Four patients (8%) failed prophylaxis and required HCV treatment with all achieving SVR (100% overall SVR). DGF occurred in 16%, BPAR in 12%, CMV viremia in 18%, and BK viremia in 16%. Mean 1-year eGFR was 57.7 ± 18.7 mL/min/1.73 m2. No DAA attributable adverse events were recorded. One-year all-cause mortality was 2% (1/50) and was unrelated to HCV or DAA. Older age (72.3 ± 4.0 vs. 62.0 ± 11.0 years, p = 0.030) and higher Estimated Post Transplant Survival (EPTS) scores (86.5 ± 19.1 vs. 61.8 ± 29.3, p = 0.041) correlated significantly with prophylaxis failure. **Conclusion:** A 4-week SOF/VEL prophylaxis regimen coupled with HCV RNA surveillance and treatment appears to be safe and effective in a Veterans Affairs population. **Keywords:** deceased donor; direct‐acting antiviral; hepatitis C virus; kidney transplantation; organ utilization; sofosbuvir/velpatasvir. Published 2026. This article is a U.S. Government work and is in the public domain in the United States. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement The authors declare no conflicts of interest. ## Figures [ ![FIGURE 1](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f0b/1342
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