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Transplantation of kidneys from hepatitis C–infected donors to hepatitis C–negative recipients: Single center experience

2019; Elsevier BV; Volume: 19; Issue: 11 Linguagem: Inglês

10.1111/ajt.15530

1600-6143

Miklos Z. Molnar, Satheesh Nair, Orsolya Cseprekál, Masahiko Yazawa, Manish Talwar, Vasanthi Balaraman, Pradeep S. B. Podila, Valeria R. Mas, Daniel G. Maluf, Ryan A. Helmick, Luís Campos, Nosratollah Nezakatgoo, Corey Eymard, Peter J. Horton, Rajanshu Verma, Ann Holbrook Jenkins, Charlotte Handley, Heather Snyder, Carolyn Cummings, Uchenna A. Agbim, Benedict Maliakkal, Sanjaya K. Satapathy, James D. Eason,

Hepatitis B Virus Studies

Our aim was to evaluate the safety of transplanting kidneys from HCV-infected donors in HCV-uninfected recipients. Data collected from 53 recipients in a single center, observational study included donor and recipient characteristics, liver and kidney graft function, new infections and de novo donor-specific antibodies and renal histology. Treatment with a direct-acting antiviral regimen was initiated when HCV RNA was detected. The mean ± SD age of recipients was 53 ± 11 years, 34% were female, 19% and 79% of recipients were white and African American, respectively. The median and interquartile range (IQR) time between transplant and treatment initiation was 76 (IQR: 68-88) days. All 53 recipients became viremic (genotype: 1a [N = 34], 1b [N = 1], 2 [N = 3], and 3 [N = 15]). The majority (81%) of recipients did not experience clinically significant increases (>3 times higher than upper limit of the normal value) in aminotransferase levels and their HCV RNA levels were in the 5 to 6 log range. One patient developed fibrosing cholestatic hepatitis with complete resolution. All recipients completed antiviral treatment and 100% were HCV RNA-negative and achieved 12-week sustained virologic response. The estimated GFRs at end of treatment and 12-week posttreatment were 67 ± 21 mL/min/1.73 m2 and 67 ± 17 mL/min/1.73 m2 , respectively. Four recipients developed acute rejection. Kidney transplantation from HCV-infected donors to HCV-negative recipients should be considered in all eligible patients.