Abstract: SA-PO1071
The Impact of Recipient's Pre-Transplant Viral Status on Acute Kidney Transplant Rejection in the United States: A Retrospective Study
Session Information
- Transplantation: Clinical - II
November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Adeyemi, Emmanuel Olusola, Saint Peter's University Hospital, New Brunswick, New Jersey, United States
- Dwivedi, Shaunak A., Saint Peter's University Hospital, New Brunswick, New Jersey, United States
- Oke, Oluwabunmi Anuoluwapo, Heatherwood Hospital, Ascot, Berkshire, United Kingdom
- Nebuwa, Chikodili N., Nuvance Health, Poughkeepsie, New York, United States
Background
Acute graft rejection is a feared complication of kidney transplant and some studies have suggested that certain viral infections could be a contributor to this feared outcome. This study therefore set out to identify the impact of some viruses on acute kidney transplant rejection in the United States.
Methods
This study used the 2010-2022 data from the Scientific Registry of Transplant Recipients. This data system includes data on all donors, waitlisted candidates and transplant recipients in the US submitted by the members of the Organ Procurement and Transplantation Network. The study included patients aged 18 years or older who had kidney transplants in the United States. Independent variables include age group of recipients, recipient’s gender, recipient’s race, donor gender, donor race, donor type, previous transplant in recipient, viral detection (HBV, HCV, HIV) in recipient at transplant time, number of HLA mismatches and pre-transplant malignancy. The dependent variable was acute rejection between transplant and discharge. Univariate, bivariate (Chi-square and t-test) and multivariable logistic regression (stepwise selection with P-value for entry and stay of a variable put at <=0.05) analyses were done using SAS 9.4.
Results
There were 207,732 kidney transplants. On multivariable logistic regression that adjusted for significant variables on bivariate analysis (age group of recipients, recipient’s race, previous transplant in recipient, number of HLA mismatches prior to transplant), transplant patients who were positive for HBV surface antigen had 57% (AOR: 95% CI 1.21-2.02) higher odds of developing acute rejection compared to those negative for the antigen. Those who had HCV detected at transplant time had 27% (AOR: 95% CI 1.07-1.49) higher odds of acute rejection compared to those who had no HCV detected. HIV positive patients had 107% (AOR: 95% CI 1.61-2.66) higher odds of developing acute rejection compared to those negative for HIV.
Conclusion
Our study has shown that viral infections (HBV, HCV, HIV) increase the risk of acute rejection in kidney transplants. These findings suggest that treating these viruses to non-detectable levels prior to transplant could reduce the risk of acute graft rejection.