Background:

The kidneys from HCV positive donors remain to be underutilized, as there are multiple studies which have shown reduced patient and graft survival rates among HCV positive kidney transplant recipients. This study was performed to determine if donor Hepatitis C status influences the outcomes of HCV positive kidney transplant recipients.

Methods:

This was a retrospective study of all HCV antibody positive kidney recipients that were transplanted between 2001-2011 at a single center. The recipients were divided by the Donor HCV status into HCV-antibody positive donors [HCV(+)D] and HCV-antibody negative donors [HCV(-)D]. Patient and graft survival were compared up to 5 years.

Results:

163 HCV positive kidney transplant recipients were analyzed: 106 in the HCV(+)D groups and 57 in the HCV(-)D group. Patient and graft survival were statistically similar (p values > 0.5).

Estimated glomerular filtration rate (eGFR) was also similar at 1, 3 or 5 years of follow up.

Patients who received kidneys from HCV(+)D were more likely to be male (p= 0.03), African American (p= 0.005), older (p=0.01), and had more HLA mismatch (p=0.004). Donor terminal creatinine was lower in HCV(+)D group, but all other demographics, including BMI, baseline diabetes, and cirrhosis were similar. The majority of patients received induction with thymoglobulin and were on calcineurin inhibitors, mycophenolate and prednisone as maintenance immunosuppression.

Conclusions:

Based on our study, donor Hepatitis C status does not seem to impact patient survival, graft survival or eGFR in HCV positive kidney transplant recipients despite the recipients of HCV(+)D in this study being older, more likely AA and with more HLA mismatch.

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