Background: Hepatitis C virus (HCV) infection has been deemed detrimental to kidney transplantation (KT) outcomes. Breakthrough HCV treatment with direct-acting antiviral (DAA) medications improved the probability of HCV+ kidney use for KT even in noninfected (HCV-) recipients. We hypothesized that recipient HCV infection influences deceased donor KT outcomes, and this effect could be modified by donor HCV status and use of DAAs.
Study Design: We conducted a retrospective cohort study based on data from the Organ Procurement and Transplantation Network as of September 2018. A mate kidneys analysis was performed with HCV+ and HCV- recipients of solitary adult KT from ABO-compatible deceased donor between January 1994 and June 2018. We selected donors where 1 KT recipient was HCV+ and the mate kidney recipient was HCV-. Both HCV- and HCV+ donors were identified and analyzed separately. Outcomes, including survival of patients, grafts, and death-censored grafts, were compared between the groups.
Results: Four-hundred and twenty-five HCV+ and 5,575 HCV- donor mate kidneys were transplanted in HCV-discrepant recipients. HCV+ recipients of HCV- donor had worse patient and graft survival (adjusted hazard ratio 1.28; 95% CI, 1.19 to 1.37 and adjusted hazard ratio 1.26; 95% CI 1.18 to 1.34, respectively) and death-censored grafts (adjusted hazard ratio 1.24; 95% CI, 1.15 to 1.34) compared with HCV- recipients. Comparable patient and graft survival and death-censored grafts were found in recipients of HCV+ donors, regardless of recipient HCV status. The risk associated with HCV positivity in donors or recipients in the pre-DAA era (before December 2013) was no longer statistically significant in the post-DAA era.
Conclusions: Given comparable outcomes between HCV+ and HCV- recipients in post-DAA era or when receiving HCV+ donor kidneys, broader use of HCV+ kidneys regardless of the recipient's HCV status should be advocated, and allocation algorithm for HCV+ kidneys should be revised.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jamcollsurg.2019.12.039 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Predicting Microvascular Invasion in Liver Transplant Recipients for Hepatocellular Carcinoma.
Cureus
December 2024
Hepatopancreatobiliary and Liver Transplant Surgery, Pakistan Kidney and Liver Institute and Research Center, Lahore, PAK.
Background: Among primary liver tumors, hepatocellular carcinoma (HCC) is considered the most common hepatic tumor. Liver transplantation is one of the curative treatment options for HCC. However, the risk of HCC recurrence after liver transplantation varies and is influenced by various factors.
View Article and Find Full Text PDFHepatitis C-positive grafts for hepatitis C-negative recipients in liver transplantation: Buried treasure or depleting resource?
Liver Transpl
December 2024
Division of Abdominal Transplant, Department of Surgery, Stanford University, Stanford, California, USA.
Long-term outcomes of using hepatitis C virus (HCV) positive donors in HCV-negative recipients in liver transplantation (LT) are not well established. Data from the United Network for Organ Sharing (UNOS) database between July 1, 2015, and December 31, 2023, were analyzed. The cohort included 44,447 HCV antibody-negative (Ab-) candidates who underwent deceased donor LT.
View Article and Find Full Text PDFMolecular test for screening malaria-infected blood donors to maximise recipient safety in Acre State, a Brazilian endemic area.
Mem Inst Oswaldo Cruz
December 2024
Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Pesquisa em Malária / Centro de Pesquisa, Diagnóstico e Treinamento em Malária, Laboratório de Referência do Ministério da Saúde para Diagnóstico de Malária na Região Extra-Amazônica, Rio de Janeiro, RJ, Brasil.
Background: Although blood transfusion is an essential therapeutic procedure, it can present risks, including transmitting infectious diseases, such as malaria. In Acre, the thick blood smear microscopic examination (TBS) is used to screen infected malaria blood donors. However, TBS has low sensitivity for detecting Plasmodium in situations of low parasitaemia, such as those presented by asymptomatic clinically healthy individuals.
View Article and Find Full Text PDFCytoskeletal Vimentin Directs Cell-Cell Transmission of Hepatitis C Virus.
Adv Sci (Weinh)
November 2024
University of Chinese Academy of Sciences, Yuquan Road No. 19(A), Shijingshan District, Beijing, 100049, P. R. China.
Hepatitis C virus (HCV) is a major human pathogen causing liver diseases. Although direct-acting antiviral agents effectively inhibit HCV infection, cell-cell transmission remains a critical venue for HCV persistence in vivo. However, the underlying mechanism of how HCV spreads intercellularly remains elusive.
View Article and Find Full Text PDFUse of Hepatitis C Viremic Donors to Expand the Pediatric Donor Pool.
Pathogens
October 2024
Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Johns Hopkins University of Medicine, Baltimore, MD 21287, USA.
The use of hepatitis C virus (HCV)-positive donors in organ transplantation has become increasingly viable due to advancements in direct-acting antiviral (DAA) therapies, which offer high cure rates. This review aims to evaluate the current practices, benefits, and challenges of utilizing HCV-positive donors for organ transplantation. The recent data show that transplant centers are progressively accepting HCV-positive donors for various organs, including kidneys, livers, and hearts, given the efficacy of post-transplant antiviral treatment.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!