Listing Practices and Graft Utilization Lag behind Supply of Hepatitis C Positive Deceased Donors for Liver and Kidney Transplant

C. E. Kling¹, J. D. Perkins², S. W. Biggins³, C. Johnson⁴, A. P. Limaye⁵, L. Sibulesky¹

¹Division of Transplant Surgery, University of Washington Medical Center, Seattle, WA, ²Division of Transplant Surgery and Clinical and Bio-Analytics Transplant Laboratory, University of Washington Medical Center, Seattle, WA, ³Divisions of Gastroenterology and Hepatology and Center for Liver Investigation Fostering DiscovEry, University of Washington Medical Center, Seattle, WA, ⁴Division of Nephrology, University of Washington Medical Center, Seattle, WA, ⁵Division of Infectious Disease, University of Washington Medical Center, Seattle, WA

Meeting: 2019 American Transplant Congress

Abstract number: D243

Keywords: Donors, marginal, Hepatitis C, Kidney transplantation, Lung transplantation

Session Information

Session Name: Poster Session D: Non-Organ Specific: Viral Hepatitis

Session Type: Poster Session

Date: Tuesday, June 4, 2019

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall C & D

*Purpose: The opioid epidemic resulted in increasing incidence of hepatitis C (HCV) in the general population and more deceased organ donors with HCV in the United States. We aimed to describe how increasing number of donors with markers of HCV infection affected patterns of liver and kidney transplantation.

*Methods: Using data supplied by United Network for Organ Sharing, we examined donor HCV antibody (Ab) and nucleic acid testing (NAT) status, wait list patterns and liver and kidney transplants performed between 2015 and 2017 by 6-month eras.

*Results: During the study period there was an increase in the number of donors with any marker of HCV (n=283 (6.2%) in Era 1 to n=384 (7.4%) in Era 5, p=0.008) and in Ab+ NAT- donors (n=81 (1.8%) in Era 1 to n=131 (2.5%) in Era 5, p<0.001). The proportion of donors with HCV directly correlated with the UNOS Region opioid death rate (R²=0.85). There was a significant increase in transplantation of Ab+ NAT- livers into aviremic recipients (n=1 (1.7%) in Era 1, to n=27 (31.0%) in Era 5, p<0.001) and from Ab+ NAT+ donors into aviremic recipients (n=2 (1.7%) in Era 1, to n=22 (14.5%) in Era 5, p<0.001). Likewise, there was a significant increase in transplantation of Ab+ NAT- kidneys into aviremic recipients, such that by the end of the study over 75% of recipients of Ab+ NAT- kidneys were aviremic (n=5 (10.6%) in Era 1 to n=97 (75.8%) in Era 5, p<0.001).

*Conclusions: Transplantation of kidneys and livers from deceased donors with HCV is becoming more common but lags behind the supply of organs.

To cite this abstract in AMA style:

Kling CE, Perkins JD, Biggins SW, Johnson C, Limaye AP, Sibulesky L. Listing Practices and Graft Utilization Lag behind Supply of Hepatitis C Positive Deceased Donors for Liver and Kidney Transplant [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/listing-practices-and-graft-utilization-lag-behind-supply-of-hepatitis-c-positive-deceased-donors-for-liver-and-kidney-transplant/. Accessed November 25, 2024.

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