Transplantation of viral-positive hepatitis C-positive kidneys into uninfected recipients offers an opportunity to increase organ access

Jay A. Graham, Julia Torabi, Maria Ajaimy, Enver Akalin, Luz E. Liriano, Yorg Azzi, Cindy Pynadath, Stuart M. Greenstein, Doctor Y. Goldstein, Amy S. Fox, Jeffery M. Weiss, Tia P. Powell, John F. Reinus, Milan M. Kinkhabwala, Juan P. Rocca

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

The advent of direct-acting antivirals (DAAs) has provided the impetus to transplant kidneys from hepatitis C virus-positive donors into uninfected recipients (D+/R−). Thirty D+/R− patients received DAA treatment. Sustained virologic response (SVR12) was defined as an undetectable viral load in 12 weeks after treatment. An age-matched cohort of uninfected donor and recipient pairs (D−/R−) transplanted during same time period was used for comparison. The median day of viral detection was postoperative day (POD) 2. The detection of viremia in D+/R− patients was 100%. The initial median viral load was 531 copies/μL (range: 10-1 × 108 copies/μL) with a median peak viral load of 3.4 × 105 copies/μL (range: 804-1.0 × 108 copies/μL). DAAs were initiated on median POD 9 (range: 5-41 days). All 30 patients had confirmed SVR12. During a median follow-up of 10 months, patient and graft survival was 100%, and acute rejection was 6.6% with no major adverse events related to DAA treatment. Delayed graft function was significantly decreased in D+/R− patients as compared to the age-matched cohort (27% vs 60%; P =.01). D+/R− transplantation offers patients an alternative strategy to increase access.

Original languageEnglish
Article numbere13833
JournalClinical Transplantation
Volume34
Issue number4
DOIs
StatePublished - 1 Apr 2020
Externally publishedYes

Keywords

  • donor-derived infections
  • donors and donation
  • hepatitis C
  • infection and infectious agents
  • kidney disease
  • viral

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