Purpose Of Review: Transplantation of kidneys from donors with a positive serology for hepatitis C virus (HCVD positive) remains controversial.
Recent Findings: Registry studies reported that the use of HCVD positive kidneys into HCV positive recipients is associated with shorter time awaiting transplantation but with a small increase in hazard for death and graft loss compared with HCVD negative. Notably, patients who received kidneys from HCVD positive have better survival than those who remain in the waitlist. A collaborative study using HCVD positive kidneys into HCVRNA positive recipients showed that HCV serology was not an independent risk factor for liver disease, graft survival, and patient survival in the long term. The safety of this approach can be improved by matching donors and recipients according to HCV genotypes. Because the incidence and prevalence of HCV infection in dialysis patients are decreasing, kidneys from HCVD positive are becoming surplus organs due to the lack of appropriate recipients in the waitlist. To improve the underutilization of these kidneys, organizational measures, including the offer of these kidneys for preemptive transplantation, are suggested.
Summary: The use of kidneys from HCVD positive into HCVR positive seems to be a safe approach in the long term, showing a better patient survival than that of HCV positive patients on the waitlist.
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Outcomes of kidney, liver, and simultaneous liver and kidney transplants from hepatitis c infected donors to hepatitis c naïve recipients: A large single center experience.
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Center for Abdominal Transplantation, SSM Health Saint Louis University Hospital, St. Louis, Missouri, USA.
Background: With the introduction of direct-acting antiviral therapies (DAAs), the non-use rate of hepatitis C virus (HCV)-positive donor organs (D+) has decreased significantly. We present the donor, recipient, and transplant allograft characteristics, along with recipient outcomes, in one of the largest cohorts of HCV-D+ transplants into HCV-naïve recipients (R-).
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J Hepatol
January 2016
AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, Villejuif F-94800, France; Univ. Paris-Sud, UMR-S 1193, Villejuif F-94800, France; Inserm, Unité 1193, Villejuif F-94800, France; Hepatinov, Villejuif F-94800, France. Electronic address:
Should organs from hepatitis C antibody positive donors (HCVD+) be used for transplantation? Organ shortage forces transplant teams to use donors with extended criteria. The decision to transplant a HCVD+ graft is a balance between the risk of transmission of a virus that could lead to end-stage liver diseases and the benefit of access to transplantation, specifically in patients with life-threatening disease. The other issue is the impact of HCV-related liver fibrosis in the donor graft on the long-term outcome in the recipient.
View Article and Find Full Text PDFTransplantation of kidneys from donors with a positive serology for hepatitis C virus (HCVD+) remains controversial as made evident by wide variations in practice. Current knowledge derived from unicenter and registry experiences have demonstrated that the use of HCVD+ kidneys in HCV+ recipients seems to be safe in the long-term. This information, summarized in this chapter, has provided the basis for internationally agreed recommendations which limit the use of these kidneys for transplantation in recipients with a positive HCV RNA while on the waiting list and consenting in advance.
View Article and Find Full Text PDFRisk of advanced fibrosis with grafts from hepatitis C antibody-positive donors: a multicenter cohort study.
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May 2012
Division of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, CA 94143, USA.
Over the last decade, the use of liver grafts from hepatitis C virus antibody-positive donors [HCV(+)Ds] has tripled in the United States. Although previous studies have demonstrated no association between an HCV(+)D status and graft loss, the effects of an HCV(+)D on histological outcomes are not well known. Hepatitis C virus (HCV)-infected recipients at 5 US centers (2002-2007) who survived more than 30 days with 1 or more posttransplant biopsy samples were included.
View Article and Find Full Text PDFShould we be using kidneys from hepatitis C virus-infected donors?
Curr Opin Nephrol Hypertens
November 2011
Organización Nacional de Trasplantes, C/ Sinesio Delgado, Carretera de Andalucía, Madrid, Spain.
Purpose Of Review: Transplantation of kidneys from donors with a positive serology for hepatitis C virus (HCVD positive) remains controversial.
Recent Findings: Registry studies reported that the use of HCVD positive kidneys into HCV positive recipients is associated with shorter time awaiting transplantation but with a small increase in hazard for death and graft loss compared with HCVD negative. Notably, patients who received kidneys from HCVD positive have better survival than those who remain in the waitlist.
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