ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Advanced Search

Timing of Treatment for Chronic Hepatitis C Infection in Patients with End-Stage Renal Disease Awaiting Transplantation

M. Eckman,1 E. Woodle,2 C. Thakar,1 F. Paterno,2 K. Sherman.1

1Medicine, University of Cincinnati, Cincinnati, OH
2Surgery, University of Cincinnati, Cincinnati, OH.

Meeting: 2018 American Transplant Congress

Abstract number: C42

Keywords: Hepatitis C, Kidney transplantation

Session Information

Date: Monday, June 4, 2018

Session Name: Poster Session C: Kidney Donor Selection / Management Issues

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

 Presentation Time: 6:00pm-7:00pm

Location: Hall 4EF

Related Abstracts
  • The THINKER Trial: Quality of Life Results at 6- and 12-Month Follow-Up among Hepatitis C-Negative Patients Who Received Kidney Transplants from Deceased Donors with Hepatitis C Infection
  • Willingness of End-Stage Renal Disease Patients (ESRD) without Hepatitis C (HCV) to Accept a HCV+ Kidney.

Background

It is unclear whether patients with chronic hepatitis C virus (HCV) infection and end-stage renal disease (ESRD) should be treated for HCV before transplant or should be transplanted with HCV+ organ and treated for HCV afterwards. The aim of this study was to evaluate the optimal HCV treatment strategy and timing in patients listed for kidney transplantation.

Methods

A Markov model with 75 transition states was built to compare the strategy of transplanting HCV-infected patients with HCV+ deceased donor kidneys, followed by anti-viral therapy for HCV versus a strategy of treating HCV-infected patients prior to transplant, then waiting for an HCV− deceased donor kidney. We performed the analysis on a hypothetical cohort of HCV infected patients receiving hemodialysis. HCV treatment included direct-acting antivirals based on genotype. Distributions of age, gender, race, and HCV genotype were based on national data from the United States. The analysis used a lifelong time horizon; main outcome measures were effectiveness measured in quality adjusted life years (QALYs), and costs in 2017 US dollars.

Results

In HCV infected patients, delaying HCV treatment after kidney transplantation with HCV+ organ was more effective and less costly than HCV antiviral treatment prior to transplantation. In the base case, a 58-year-old male receiving hemodialysis would gain an average of 0.22 quality-adjusted life years with lifetime cost savings of $24,358 with the strategy of HCV treatment after transplantation. The superiority of the transplant with HCV+ kidney strategy was robust in sensitivity analyses of the main model parameters. In probabilistic sensitivity analyses of 10,000 second-order Monte Carlo simulations, transplantation with an HCV+ donor kidney was preferred over HCV treatment followed by kidney transplantation with an HCV− donor kidney 92.9 % of the time.

Conclusions

Although new effective antiviral agents for HCV are available for patients with ESRD, the shorter waiting time in case of transplantation with HCV+ deceased donor kidneys results in higher quality-adjusted life expectancy and lower cost compared with a strategy of HCV treatment prior to transplantation. In the current age of increasing organ demand that far outstrips donor supply, a strategy of transplantation of HCV+ kidneys followed by treatment of HCV infection

may be both effective and cost saving.

CITATION INFORMATION: Eckman M., Woodle E., Thakar C., Paterno F., Sherman K. Timing of Treatment for Chronic Hepatitis C Infection in Patients with End-Stage Renal Disease Awaiting Transplantation Am J Transplant. 2017;17 (suppl 3).

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Eckman M, Woodle E, Thakar C, Paterno F, Sherman K. Timing of Treatment for Chronic Hepatitis C Infection in Patients with End-Stage Renal Disease Awaiting Transplantation [abstract]. https://atcmeetingabstracts.com/abstract/timing-of-treatment-for-chronic-hepatitis-c-infection-in-patients-with-end-stage-renal-disease-awaiting-transplantation/. Accessed February 28, 2021.

« Back to 2018 American Transplant Congress

Most Viewed Abstracts

  • This Week
  • This Month
  • All Time
  • A Decade of Donor-Derived Disease: A Report of the OPTN Ad Hoc Disease Transmission Advisory Committee (DTAC).
  • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
  • Subtherapeutic Low Tacrolimus Trough Levels (≤3.5 Ng /ml) Are A Risk Factor For Acute Rejection And Creatinine Doubling.
  • Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI?
  • Kidney Dialysis after Heart Transplantation: The Short and Long Term Outcomes
  • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
  • Subtherapeutic Low Tacrolimus Trough Levels (≤3.5 Ng /ml) Are A Risk Factor For Acute Rejection And Creatinine Doubling.
  • Penis Transplantation: First U.S. Experience.
  • A Decade of Donor-Derived Disease: A Report of the OPTN Ad Hoc Disease Transmission Advisory Committee (DTAC).
  • Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI?
  • Penis Transplantation: First U.S. Experience.
  • Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI?
  • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
  • Evidence of a Clinically Significant Drug-Drug Interaction between Cannabidiol and Tacrolimus: A Case Report
  • Kidney Dialysis after Heart Transplantation: The Short and Long Term Outcomes

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2021 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.