Kidney Week

Abstract: TH-PO1005

Survival Benefit of Opting In for Receiving a Kidney Transplant from a Hepatitis C (HCV) Nucleic Acid Test-Positive (NAT+) Deceased Donor

Session Information

• Transplantation: Clinical - Outcomes, Malignancy, and Pathology
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2002 Transplantation: Clinical

Authors

• Schaubel, Douglas E., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States

Douglas E. Schaubel, MSc, PhD

• Song, Nianfu, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States

Nianfu Song

• Blanco, Maria C., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States

Maria C. Blanco

• Kuzla, Natalie, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States

Natalie Kuzla, MA

• Goldberg, David S., University of Miami Miller School of Medicine, Miami, Florida, United States

David S. Goldberg, MD, MS

• Reese, Peter P., Vanderbilt University Medical Center, Nashville, Tennessee, United States

Peter P. Reese, MD, PhD

Group or Team Name

• THINKER-NEXT Study Group

Background

Recent literature has indicated that survival after deceased donor kidney transplant (DDKT) is not affected by the presence of donor HCV RNA by nucleic acid testing (NAT+). We sought to determine if there is a survival benefit for waitlisted patients who opt in for receiving offers of a DDKT from a HCV NAT+ donor.

Methods

Data were obtained from the Scientific Registry of Transplant Recipients (SRTR). The study population included adult patients initially wait-listed for KT during 2016-23 (n=75,260 after exclusions and matching). Exposed “cases” opted in for receiving offers of a DDKT from deceased-donor KT from a HCV NAT+ donor, with follow-up then starting at the time (post-listing) of opt-in. Each case was 1:1 matched to a comparator who was alive, uncensored, not-yet-transplanted, and most “similar” to the case (same center, within 5 years of age, closest propensity score within 5% of the case) but had not opted in for HCV NAT+ DDKT offers. Five-year total survival (from opt-in/matching, not censored at DDKT) was compared by the log rank test.

Results

Forty-five percent of patients opted in. Median follow-up was 1.9 years post-matching. There were 9,875 deaths (13% of study population). Five-year survival (Fig 1) was significantly greater (p<0.0001) for cases (76.4%) than comparators (71.5%). The percentage of patients receiving a DDKT was much greater for cases (39.6%) than matched comparators (32.6%). Approximately 20% of the DDKT received by cases were HCV NAT+.

Conclusion

Wait-listed kidney patients who opted in for HCV NAT+ DDKT experienced 5% higher patient survival (from opt-in forward) over five years. This finding should be shared with patients who are considering donor offer criteria.

Acknowledgment

This work was funded by the National Institutes of Health (NIDDK) via the THINKER-NEXT study (U01-DK126654).

Funding

• NIDDK Support