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Kidney Week

Abstract: PO2442

Transplantation of Kidneys from Hepatitis C-Infected Donors to Hepatitis C-Negative Recipients: 1-Year Renal Allograft Outcomes

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Molnar, Miklos Zsolt, Methodist University Hospital, Memphis, Tennessee, United States
  • Azhar, Ambreen, Methodist University Hospital, Memphis, Tennessee, United States
  • Tsujita, Makoto, Methodist University Hospital, Memphis, Tennessee, United States
  • Talwar, Manish, Methodist University Hospital, Memphis, Tennessee, United States
  • Balaraman, Vasanthi, Methodist University Hospital, Memphis, Tennessee, United States
  • Bhalla, Anshul, Methodist University Hospital, Memphis, Tennessee, United States
  • Kovesdy, Csaba P., The University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Nair, Satheesh P., Methodist University Hospital, Memphis, Tennessee, United States
  • Eason, James D., Methodist University Hospital, Memphis, Tennessee, United States

Group or Team Name

  • Methodist Transplant Epidemiology Research Group
Background

Transplant centers in United States are increasingly willing to transplant kidneys from hepatitis C (HCV) infected donors to hepatitis C negative recipients. Long-term renal outcome data of a non-prophylactic HCV treatment approach outside clinical trials is missing.

Methods

We examined 65 HCV negative recipients who received a HCV infected kidney transplant (HCV+) and 59 HCV negative recipients who received a HCV non-infected kidney transplant (HCV-) during 2018 in a single transplant center. We compared estimated glomerular filtration rate (eGFR), cumulative results of per-cause and surveillance protocol biopsies, development of de novo donor specific antibodies (DSAs), co-infection rates and patient and graft outcomes up to 1 year post-transplant between HCV+ versus HCV- groups.

Results

The mean±SD age of recipients was 52±11 years, 43% were female, 19% and 80% of recipients were Caucasian and African-American, respectively. Baseline characteristics were similar between the HCV+ and HCV- groups. The delayed graft function rate, estimated GFRs at post-transplant 3, 6, 9 and 12 months, cumulative rejection rate, development of de novo DSAs and co-infection rates were not statistically significantly different between the HCV+ and HCV- groups (Table).

Conclusion

Recipients of HCV-viremic kidneys have similar renal allograft function, incidence of rejection in the first year after transplantation compared to those who received HCV-non-viremic kidneys.

Renal graft and patient outcome of all kidney transplant recipients
 Entire CohortHCV+HCV-p-value
Observations (n) 1246559N/A
Delayed Graft Function, N, (%)12 (10%)5 (12%)7 (8%)0.43
Estimated GFR at 3 months after transplantation (ml/min/1.73m2), mean (SD) 63 (20)63 (18)64 (21)0.85
Estimated GFR at 6 months after transplantation (ml/min/1.73m2), mean (SD) 66 (19)66 (18)66 (21)0.96
Estimated GFR at 9 months after transplantation (ml/min/1.73m2), mean (SD) 67 (18)66 (15)67 (20)0.62
Estimated GFR at 12 months after transplantation (ml/min/1.73m2), mean (SD)66 (19)64 (16)66 (22)0.69
ACR/ABMR (N of patient / N of patients with biopsy result (%))26/113 (23%)13/54 (24%)13/59 (22%)0.80
De novo DSA (N of patient / N of patients with DSA result (%))26/94 (28%)20/64 (31%)6/30 (20%)0.26
BK viremia (>10,000 copies) (N (%))19 (16%)12 (18%)7 (13%)0.42
CMV viremia (>1,000 copies) (N (%))15 (12%)11 (17%)4 (7%)0.10
Death (N (%)) 4 (3%)1 (2%)3 (5%)0.26
Graft Loss (including death) (N (%))7 (6%)1 (2%)6 (10%)0.04