Long-term outcomes and transmission rates in hepatitis C virus-positive donor to hepatitis C virus-negative kidney transplant recipients: Analysis of United States national data

Gaurav Gupta, Le Kang, Jonathan W. Yu, Ashley J. Limkemann, Victoria Garcia, Dipankar Bandyopadhyay, Dhiren Kumar, Hasan Fattah, Marlon Levy, Adrian H. Cotterell, Amit Sharma, Chandra Bhati, Trevor Reichman, Anne L. King, Richard Sterling

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

The use of kidneys from hepatitis C virus (HCV)-positive (D+) deceased donors for HCV-negative recipients (R−) might increase the donor pool. We analyzed the national Organ Procurement and Transplant Network (OPTN) registry from 1994 to 2014 to compare the outcomes of HCV D+/R− (n = 421) to propensity-matched HCV-negative donor (D−)/R− kidney transplants, as well as with waitlisted patients who never received a transplant, in a 1:5 ratio (n = 2105, per matched group). Both 5-year graft survival (44% vs 66%; P <.001) and patient survival (57% vs 79%; P <.001) were inferior for D+/R− group compared to D−/R−. Nevertheless, 5-year patient survival from the time of wait listing was superior for D+/R− when compared to waitlisted controls (68% vs 43%; P <.001). Of the 126 D+/R− with available post-transplant HCV testing, HCV seroconversion was confirmed in 62 (49%), likely donor-derived. Five-year outcomes were similar between D+/R− that seroconverted vs D+/R− that did not (n = 64). Our analysis shows inferior outcomes for D+/R− patients although detailed data on pretransplant risk factors was not available. Limited data suggest that HCV transmission occurred in half of HCV D+/R− patients, although this might not have been the primary factor contributing to the poor observed outcomes.

Original languageEnglish (US)
Article numbere13055
JournalClinical Transplantation
Volume31
Issue number10
DOIs
StatePublished - Oct 2017

Keywords

  • donor-derived transmission
  • hepatitis C-negative recipients
  • hepatitis C-positive donors
  • kidney transplantation
  • long-term outcomes

Fingerprint Dive into the research topics of 'Long-term outcomes and transmission rates in hepatitis C virus-positive donor to hepatitis C virus-negative kidney transplant recipients: Analysis of United States national data'. Together they form a unique fingerprint.

Cite this