Patients without HCV can take transplants from donors with HCV without risking graft survival
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Transplanting kidneys from donors who have the hepatitis C virus into patients who are HCV-negative is not associated with increased risk for early graft failure, according to a presentation at the American Transplant Congress.
“With the excellent outcomes of the new therapy of hepatitis in the last few years, we intend to examine the kidney transplant outcomes using kidneys from donors with hepatitis C,” Tarek Alhamad, MD, MS, the medical director of kidney transplantation at Washington University, told Healio.
Further, researchers sought to determine their findings in the context of “the modern era of direct-acting antiviral medications.”
Researchers examined 41,942 adults who were HCV-negative with information in the Organ Procurement and Transplantation Network database. All patients received their first kidney transplant between Feb. 28, 2018, and July 6, 2021.
During a 3-year follow-up, researchers used Cox proportional hazards regression to determine hazard ratios for graft failure by donor HCV status. Researchers adjusted for multiple transplant and donor and recipient characteristics. Additionally, researchers addressed recipient characteristics using a propensity score that predicted patient selection to receive an NAT-positive or Ab-positive/NAT-negative kidney in the model.
Overall, 1,689 patients received an HCV Ab-positive/NAT-negative kidney and 2,331 received a NAT-positive kidney. Researchers identified 2,752 patients who experienced kidney transplant failure during a median of 364 days of follow-up. Analyses revealed Ab-positive/NAT-negative and NAT-positive status correlated with non-significantly lower risks of kidney transplant failure compared with donor HCV Ab-negative/NAT-negative status.
“[These findings] show clear evidence that kidneys from donors with hepatitis C do not carry any higher risk of kidney failure or patient death. This will improve the utilization of these organs and increase the transplant volume,” Alhamad told Healio. “More efforts are needed to create a modified donor risk index that does not include HCV as a risk factor. This will decrease the discard rate of such valuable organs.”
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Alhamad T. et al. Abstract 201. Presented at: American Transplant Congress; June 4-8, 2022; Boston (hybrid meeting).
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