Twelve‐month kidney and liver outcomes of kidney transplantation from Hepatitis C Viremic deceased donors to aviremic recipients

Introduction: Utilization of hepatitis C viremic (HCV+) deceased donor kidneys (DDKT) for aviremic recipients increases opportunities for transplantation with excellent short-term outcomes. Our primary aim was to understand longer-term outcomes, specifically assessing kidney and liver function in the first year posttransplant. Methods: This was a retrospective single-center study of adult DDKT recipients of HCV+ kidneys (cases) matched 1:1 to recipients of HCV- kidneys (comparators). Between-group outcomes were analyzed using comparisons of means and proportions, survival analysis methods, and multivariable mixed effects models. Results: Sixty-five cases and 65 comparators had statistically comparable demographic and clinical characteristics. There were no between-group differences in serum creatinine or estimated glomerular filtration rate at month 12 (p =.662) or in their trajectories over months 1–12 (p >.292). Within the first 60 days, rates of liver function values >3 times upper limit of normal among cases were comparable to comparators for aspartate aminotransferase (AST) (14% vs. 6%, p =.242) and higher for alanine transaminase (ALT) (23% vs. 6%, p =.011). AST declined during the first 8 weeks (p =.005) and stabilized for both groups (p =.406) during the following 10 months. ALT declined during the first 8 weeks (p <.001), continued to decline over months 3–12 (p =.016), and the trajectory was unrelated to antiviral therapy initiation among cases. Conclusions: Aviremic recipients of HCV+ kidneys had comparable kidney outcomes to matched recipients of HCV- kidneys. Despite more HCV+ recipients having an elevation in ALT within the first 60 days, ALT values normalized with no identified liver complications attributed to HCV. (Figure presented.).