Patient survival is better for hepatitis C-negative (HCV-) than hepatitis C-positive (HCV+) recipients of an HCV+ deceased donor kidney, investigators reported at the virtual American Transplant Congress 2021.
In a mate kidney analysis, researchers identified 134 HCV+ deceased donors from whom 1 kidney was transplanted into a HCV+ recipient and the mate kidney was transplanted into an HCV- recipient, using the 2015-2019 Organ Procurement and Transplantation Network (OPTN) – United Network for Organ Sharing (UNOS) database.
After a median follow-up of 7 months, delayed graft function (DGF) developed in 33 HCV+ and 30 HCV- recipients, a nonsignificant difference between the groups, Kalathil K. Sureshkumar, MD, of Allegheny General Hospital in Pittsburgh, Pennsylvania, and colleagues reported. More graft losses (11 vs 4) and patient deaths (7 vs 2) occurred in the HCV+ than HCV- group, the investigators found. After Kaplan-Meier analysis, significantly higher patient survival was found among HCV- than HCV+ recipients.
“Superior patient survival in HCV- group is reflective of the overall better health status of HCV- compared to HCV+ kidney recipients,” according to Dr Sureshkumar’s team.
Although graft survival appeared higher for the HCV- group, death-censored graft survival was comparable. “These findings indicate fewer deaths with functioning grafts in the HCV- group,” according to the investigators.
“The availability of highly effective direct-acting antiviral agents has been revolutionary in the treatment of hepatitis C,” Dr Sureshkumar told Renal & Urology News. “Compared with previous treatments, these agents have minimal side effects, are well-tolerated, and are highly effective. Many of these agents can be used in patients with decreased kidney function and have minimal interaction with anti-rejection, immunosuppressive medications. This enables safe use of these agents following kidney transplantation. Our study found a drastic reduction in waiting time for kidney transplant to 12 months or less.”
Mate kidney transplants increased from 5.2% in 2015 to 7.5% in 2016, 10.5% in 2017, 33.6% in 2018, and 43.3% in 2019, the investigators reported.
Sureshkumar KK, Chopra B, McGill RL. Outcomes of kidney transplantation from hepatitis C virus (HCV) infected donors stratified by recipient HCV serostatus: a mate kidney analysis. Am J Transplant. 2021;21(suppl 3). Presented at the virtual American Transplant Congress, June 5-9, 2021. Abstract 362.