Kidney Grafts From HCV-Positive Donors: Advantages and Disadvantages

Abstract The Organ Procurement and Transplantation Network database (2001–2006) was reviewed for kidney transplant (KT) recipients, to evaluate the effects of use of grafts from donors positive for hepatitis C virus (HCV) on recipient outcome. Data for 76,787 de novo adult KT recipients were include...

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Bibliographic Details
Published in:Transplantation proceedings 2010-09, Vol.42 (7), p.2436-2446
Main Authors: Maluf, D.G, Archer, K.J, Mas, V.R
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Biological and medical sciences
Cadaver
Databases as Topic
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Hepatitis C - complications
Humans
Kidney Transplantation - methods
Kidney Transplantation - mortality
Kidney Transplantation - physiology
Length of Stay
Living Donors
Medical sciences
Middle Aged
Regression Analysis
Retrospective Studies
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Time Factors
Tissue Donors
Tissue, organ and graft immunology
Waiting Lists
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Summary:Abstract The Organ Procurement and Transplantation Network database (2001–2006) was reviewed for kidney transplant (KT) recipients, to evaluate the effects of use of grafts from donors positive for hepatitis C virus (HCV) on recipient outcome. Data for 76,787 de novo adult KT recipients were included in the analysis. Serologic tests revealed HCV positivity in 6.25% of cadaver kidneys and 2.97% of living-donor kidneys. Median follow-up in patients still alive was 36 months. At multivariable Cox regression analysis in recipients of cadaver kidney, HCV serostatus was significantly associated with overall and graft survival (both P < .001), with a hazard ratio for HCV-positive patients of 1.43 for overall survival and 1.48 for graft survival. Similar results were obtained for living-donor kidney recipients. Recipients of HCV-positive organs tended to be male and African American and to have a shorter waiting time. Infection was the most commonly reported cause of death in recipients of organs from HCV-positive donors. In patients willing to accept HCV-positive grafts (929 [25.6%]), waiting time was significantly shortened ( P < .001). However, this benefit was offset by decreased patient survival ( P < .001) and graft survival ( P = .007).
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2010.04.056