The Trend of Non-Utilization and Decline of Hepatitis C Virus Antibody-Positive Deceased Donor Kidneys

S. Chang¹, K. Lentine², D. Axelrod³, J. Wellen¹, M. Wang¹, M. A. Schnitzler⁴, T. Alhamad⁵

¹Surgery, Washington University School of Medicine, Saint Louis, MO, ²Surgery, Saint Louis University, Saint Louis, MO, ³Surgery, University of Iowa, Iowa City, IA, ⁴Surgery, Sanit Louis University, Saint Louis, MO, ⁵Washington University School of Medicine, Saint Louis, MO

Meeting: 2020 American Transplant Congress

Abstract number: C-018

Keywords: Allocation, Donation, Hepatitis C, Kidney

Session Information

Session Name: Poster Session C: Kidney Deceased Donor Allocation

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: With more transplant centers are accepting hepatitis C virus infected (HCV+) deceased donor kidneys (dHCV+), the trend of non-utilization and decline of these organs have not been re-examined.

*Methods: We used data from the national Organ Procurement and Transplantation Network on deceased donor kidneys between Jan 2000 and Dec 2018 in the United States. Kidney non-utilization for HCV+ was defined as a positive donor HCV status and positive hepatitis as the reason for non-utilization. dHCV+ kidney decline was defined as a donor HCV+ status among kidneys recovered for transplantation but not transplanted. We assessed associations of a dHCV+ status with kidney non-utilization or decline, adjusted for donor characteristics (age, race, sex, body mass index, diabetes, hypertension, kidney donor profile index), using multivariable logistic regression.

*Results: A total of 274,570 deceased donor kidneys procured for transplantation between 2000 and 2018 were identified. Among these kidneys, 4.1% were from dHCV+. Proportion of dHCV+ non-utilization among all non-utilized kidneys increased from 2000-2005 (3.9%) and then subsequently declined. This proportion increased slightly to 1.1% in 2014 and decreased to 0.5, 0.8, 0.4, 0.6% in 2015-2018, respectively. Multivariable-adjusted odds ratios for dHCV+ non-utilization and decline by year demonstrate consistently an increasing trend from 2000-2006 followed by a decreasing trend from 2006-2011 (Fig A-B). Multivariable-adjusted odds ratios for dHCV+ (compared to dHCV-) non-utilization and decline increased to 6.56 (95% CI 5.30-8.12) and 6.66 (95% CI 5.39-8.24), respectively, in 2012, and decreased to 2.32 (95% CI 2.01-2.69) and 2.28 (95% CI 1.98-2.64), respectively, in 2018.

*Conclusions: dHCV+ non-utilization and decline have decreased in the last few years, particularly after 2014. 2018 had a historic lowest odds ratio for non-utilization and decline of dHCV+ organs, which reflects the increased acceptability of transplant centers to these kidneys. Overall, since 2014, the odds ratios for dHCV+ non-utilization and decline decreased by half. Yet, there is more room for decreasing the non-utilization and decline for these potentially life-saving organs.

To cite this abstract in AMA style:

Chang S, Lentine K, Axelrod D, Wellen J, Wang M, Schnitzler MA, Alhamad T. The Trend of Non-Utilization and Decline of Hepatitis C Virus Antibody-Positive Deceased Donor Kidneys [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/the-trend-of-non-utilization-and-decline-of-hepatitis-c-virus-antibody-positive-deceased-donor-kidneys/. Accessed November 22, 2024.

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