Twelve Month Outcomes of Kidney Transplantation from Hepatitis C Viremic Deceased Donors to Aviremic Recipients
L. A. Binari, R. C. Forbes, S. Rega, I. D. Feurer, A. Dreher, S. Shawar, H. Schaefer, D. Shaffer, B. P. Concepcion
Vanderbilt University Medical Center, Nashville, TN
Meeting: 2022 American Transplant Congress
Abstract number: 1646
Keywords: Hepatitis C, Kidney transplantation, Renal function
Topic: Clinical Science » Infection Disease » 27 - Non-Organ Specific: Viral Hepatitis
Session Information
Session Name: Non-Organ Specific: Viral Hepatitis
Session Type: Poster Abstract
Date: Tuesday, June 7, 2022
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Halls C & D
*Purpose: The utilization of Hepatitis C viremic (HCV+) deceased donor kidneys for uninfected recipients allows for increased opportunities for organ transplantation. Initial studies have indicated similar short-term graft outcomes in comparison to recipients of hepatitis C negative (HCV-) donors. Our aim was to understand longer term outcomes by assessing rejection-free survival, graft function, and patient and graft survival of HCV+ donor to HCV- recipient kidney transplants over the first posttransplant year.
*Methods: This was a retrospective single-center study of deceased donor kidney transplant (DDKT) recipients of HCV+ kidneys (cases) who were matched 1:1 to recipients of HCV- kidneys (controls) by age, gender, race, history of diabetes, kidney donor profile index (KDPI) and calculated panel reactive antibody (cPRA). Data were analyzed using summary statistics, analysis of variance, chi-square tests, Kaplan-Meier survival methods, and multivariable mixed effects models of longitudinal serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) data.
*Results: The sample included 65 cases and 65 controls who had statistically comparable demographic and clinical characteristics. Mean age of recipients was 55±11 years, mean KDPI 25±17%, mean cPRA 16±30%, 69% male, 57% white, 95% hypertensive, and 45% diabetic. The majority of patients received alemtuzumab for induction (91%). All were maintained on calcineurin inhibitor and mycophenolate mofetil for maintenance immunosuppression, with 58% controls and 9% cases on steroid-sparing regimens. Among cases, 64 of 65 (98%) achieved a sustained virologic response at 12 weeks posttreatment with a first course of direct acting antivirals. There was no significant difference between cases and controls over the first posttransplant year in terms of patient survival (p=0.093), death-censored graft survival (p= 0.141), or rejection-free graft survival (p=0.164). After adjusting for delayed graft function (p<0.05), overall SCr showed a statistically marginal increase (p=0.045) and eGFR was statistically stable (p=0.464) between posttransplant day 31 and month 12, and there were no between-group differences in the temporal trajectories (time by group interaction p>0.292) or the overall values of SCr or eGFR (p>0.346). At approximately 12 months posttransplant, mean eGFR was 58.6±17.3 and 56.3±2.1 (p =0.470) and mean SCr was 1.29±0.57 and 1.34±0.64 (p=0.662) for cases and controls, respectively.
*Conclusions: Aviremic recipients of HCV+ kidneys had comparable rejection-free survival, graft function and graft survival at 12 months posttransplant compared to HCV- matched controls.
To cite this abstract in AMA style:
Binari LA, Forbes RC, Rega S, Feurer ID, Dreher A, Shawar S, Schaefer H, Shaffer D, Concepcion BP. Twelve Month Outcomes of Kidney Transplantation from Hepatitis C Viremic Deceased Donors to Aviremic Recipients [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/twelve-month-outcomes-of-kidney-transplantation-from-hepatitis-c-viremic-deceased-donors-to-aviremic-recipients/. Accessed December 5, 2024.« Back to 2022 American Transplant Congress