Patients not infected with hepatitis C virus (HCV) who receive a kidney from an HCV-positive donor have outcomes in the first year after transplantation similar to those of HCV-negative patients who receive kidneys from HCV-negative donors, findings from a new study suggest.

In a retrospective cohort study, Miklos Z. Molnar, MD, PhD, of the University of Tennessee Health Science Center in Memphis, Tennessee, and colleagues studied 65 HCV-negative recipients who received a kidney from an HCV-positive donor and 59 HCV-negative recipients of a kidney from an HCV-negative donor during 2018 at a single transplant center. The study population had a mean age of 52 years; 43% of patients were female, and 80% and 19% of recipients were of Black and White race, respectively. The HCV-positive and HCV-negative groups had similar baseline characteristics.

The HCV-positive and HCV-negative groups did not differ significantly with respect to delayed graft function rates (12% vs 10%), estimated glomerular filtration (eGFR) rates at 3, 6, 9, and 12 months after transplant, proportion with antibody mediated rejection (7% vs 10%), proportion of patients with cellular rejection (6% vs 7%), and development of de novo donor-specific antibodies (31% vs 20%), the investigators reported in the American Journal of Kidney Diseases. The graft loss rate was significantly lower among recipients of kidneys from HCV-positive compared with HCV-negative donors (2% vs 10%).

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Transplantation of kidneys from HCV-positive donors to HCV-negative recipients

offers excellent 1-year posttransplant outcomes, according to Dr Molnar’s team. All recipients of kidneys from HCV-positive donors cleared their HCV RNA levels after transient viremia while maintaining similar good allograft function compared with recipients of kidneys from HCV-negative donors, the investigators reported.

Although the study included the largest cohort to date of HCV-negative recipients receiving HCV-infected donor kidneys, it still is limited by its relatively small sample size, Dr Molnar and colleagues noted. Another limitation is the inclusion of patients from a single center, which limits generalizability of the results.


Molnar MZ, Azhar A, Tsujita, M, et al. Transplantation of kidneys from hepatitis C virus-infected donors to hepatitis C virus-negative recipients: One-year kidney allograft outcomes. Published online December 14, 2020. Am J Kidney Dis. doi:10.1053/j.ajkd.2020.10.017.