The Trend of Non-Utilization and Decline of Hepatitis C Virus Antibody-Positive Deceased Donor Kidneys
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 December 2, 2024.« Back to 2020 American Transplant Congress