*Purpose: HCV nucleic acid testing (NAT) testing for deceased donors (DD) has been routine since 2015. We intended to look at utilization/discard rates based on donor NAT and antibody (Ab) status. Two recent trials show promising outcomes from transplanting viremic donor kidneys to a negative recipient.

*Methods: We queried the UNOS dataset for all deceased donor kidneys between January 2015 and December 2017.. The final study cohort (N= 55,842) were stratified into 3 groups: 1) Ab-/NAT- (n = 52,106); 2) Ab+/NAT- (n = 1,272); and 3) Ab+/NAT+ (n= 2,464).

*Results: We noted a consistent decrease in discard of Ab+/NAT- kidneys with concomitant increase in transplantation (Fig 1) and an increase in NAT+ donor kidneys. We forecast (utilizing time series exponential smoothing) based on trend between 2015 and 2017, that number of HCV viremic donor will increase to approximately 800 in 2020 Fig 2.

*Conclusions: Ab+/NAT- kidney transplants increased significantly in the study period. An increase in number of HCV positive and a parallel increase in such kidney utilization (especially from HCV positive kidneys to HCV negative recipients) may increase the DD pool and access to transplantation.

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