Background: Prior to the new KAS, transplantation with HCV+ compared to HCV- kidneys provided shorter waiting times on the deceased donor list. In the current era of the new KAS, waiting times for HCV+ compared to HCV- kidneys have yet to be reported.

Methods: HCV+ patients at our center are listed for HCV+ deceased donor kidneys after informed consent. With the advent of DAAs which are highly effective post-transplant, our center delays treatment of HCV until after transplant to allow HCV+ patients with stage ≤2 fibrosis to list for HCV+ kidneys. We performed a retrospective review of all patients who received a deceased donor kidney transplant at our center from 12/4/14-7/31/16. Patient baseline clinical characteristics and post transplant outcomes were collected and HCV+ kidney recipients were compared to HCV- recipients. Statistical analysis with Chi-square and Student t test were used where appropriate.

Results: 35 patients were transplanted during the study period. 7/35 (20%) were HCV+ and all received HCV+ kidneys. There was no significant difference in patient clinical characteristics between the HCV+ and HCV- groups: mean age 62 vs 58 years (p=0.29), 71% vs 61% white (p=0.8), 57% vs 46% blood type O (p=0.86), 71% vs 68% PRA 0 (p=0.26), 43% vs 11% KDPI >85% (p=0.17). However, HCV+ compared to HCV- recipients had significantly shorter waiting list qualifying times prior to transplant for mean and median days (983 vs. 2568 days and 1112 vs. 2856 days, respectively, p<0.001). 6/7 HCV+ patients completed HCV treatment with DAAs and achieved SVR. 1/7 patients is currently undergoing treatment. All 7 HCV+ patients are alive with a functioning graft and no acute rejection episodes. Mean serum creatinine is 1.5 mg/dL with a median follow-up of 496 days.

Conclusions

In the era of the new KAS, analysis of a small-volume center with an older and largely unsensitized population demonstrated that patients who underwent HCV+ kidney transplantation waited approximately 4-5 years less on the deceased donor kidney transplant list compared to their HCV- counterparts. Our study provides evidence for supporting a practice of delaying HCV treatment until after transplantation to allow HCV+ patients to list for HCV+ kidneys and benefit from shorter waiting times. The effect of this practice on overall patient survival requires further investigation.

CITATION INFORMATION: Concepcion B, Langone A, Edmundson B, Johnson J, Rajput A, Johnson T, Rybacki D, Hale D, Forbes R. Transplantation of Hepatitis C Kidneys to Hepatitis C Recipients Confers Significantly Shorter Waiting Times in the Era of the New Kidney Allocation System. Am J Transplant. 2017;17 (suppl 3).

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