Intermediate-term outcomes of hepatitis C-positive compared with hepatitis C-negative deceased-donor renal allograft recipients

Abstract Background Prior studies have yielded conflicting results concerning the impact of HCV on renal transplant outcomes. Methods We examined outcomes in comparable groups of predominantly African American hepatitis C virus (HCV)-positive (n = 34) and HCV-negative (n = 111) kidney transplant pat...

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Published in:The American journal of surgery 2008-03, Vol.195 (3), p.298-303
Main Authors: Brown, Kristian L., M.D, El-Amm, Jose M., M.D, Doshi, Mona D., M.D, Singh, Atul, M.D, Morawski, Katherina, R.N, Cincotta, Elizabeth, Pharm.D, Siddiqui, Firdous, M.D, Losanoff, Julian E., M.D, West, Miguel S., M.D., F.A.C.S, Gruber, Scott A., M.D., Ph.D., M.B.A., F.A.C.S
Format: Article
Language:English
Subjects:
Acute rejection
African American
Body mass index
Cytomegalovirus
Diabetes Mellitus
Early corticosteroid withdrawal
Female
Graft Survival
Hepatitis C
Humans
Kidney transplantation
Kidney Transplantation - mortality
Liver diseases
Male
Middle Aged
New-onset diabetes mellitus
Patients
Polymerase chain reaction
Retrospective Studies
Studies
Surgery
Tissue Donors
Transplantation, Homologous
Transplants & implants
Treatment Outcome
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Summary:Abstract Background Prior studies have yielded conflicting results concerning the impact of HCV on renal transplant outcomes. Methods We examined outcomes in comparable groups of predominantly African American hepatitis C virus (HCV)-positive (n = 34) and HCV-negative (n = 111) kidney transplant patients receiving contemporary immunosupppression. Results There was no difference in patient survival or acute rejection, but new-onset diabetes (NODM) was increased and graft survival decreased in the HCV-positive group, with increased graft loss secondary to noncompliance and Type I MPGN. The incidence of NODM among patients undergoing early corticosteroid withdrawal was 11% in both groups, while among those on prednisone, it was 47% in HCV-positive versus 25% in HCV-negative recipients. Conclusions Deceased-donor HCV-positive renal allograft recipients have equivalent patient but decreased graft survival. Noncompliance and Type I MPGN play a role in producing this negative effect on graft outcome. Steroids may be required for HCV to exert its diabetogenicity in kidney transplant patients.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2007.12.005