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Utilization of HCV-Positive Donors' Kidneys: Potential Benefits in the Era of Direct Acting Antiviral (DAA) Therapy.

B. Amundsen,1 M. Sise,2 M. Lin,3 H. Deirawan,1 E. Heher,2 B. Kimball,1 J. Markmann,1 N. Elias.1

1Massachusetts General Hospital, Boston, MA
2Massachusetts General Hospital, Boston, MA
3Brigham and Women's Hospital, Boston, MA.

Meeting: 2016 American Transplant Congress

Abstract number: 75

Keywords: Cadaveric organs, Donation, Hepatitis C, Kidney transplantation

Session Information

Date: Sunday, June 12, 2016

Session Name: Concurrent Session: SOT: HIV, HBV, & HCV

Session Time: 2:30pm-4:00pm

 Presentation Time: 3:42pm-3:54pm

Location: Room 313

Related Abstracts
  • Utilization and Discard of HCV+ Donor Livers in the Advent of Direct-Acting Antiviral Therapy.
  • Utilization and Post-Transplant Outcomes Associated with Hepatitis C+ Donor Kidneys in the Advent of Direct-Acting Antivirals.

Organ shortage and expanding kidney waiting list fostered utilization of HCV positive donors' organs (HCVD+). HCVD+ kidneys have slightly worse long term outcomes compared with HCV- kidneys, but better outcomes compared to remaining on the waiting list. Using HCVD+ for HCV+ patients may shorten waiting times decreasing its mortality. Limited early data of novel HCV DAA therapy in this population is promising, and may improve HCVD+ outcome.

To evaluate HCVD+ kidney utilization and post-transplant HCV therapy, we retrospectively reviewed charts of kidney transplant recipients between 1/1/2010 and 8/31/2015 at our institution.

Multi-organ and living donor transplants were excluded. Of the remaining 305 deceased donor transplants, only 15 (5%) were from HCVD+. HCVD+ kidney recipients' had shorter waiting time and mean KDPI of 46% (Table1 and 2).

All of the HCVD+ kidney recipients have functioning allografts. Neither HCV genotype switches, nor new infections were noted among recipients. Eleven (73%) had HCV treated post transplant with DAA. Five of those (46%) achieved sustained virological response. Six remain on therapy. Four have not initiated treatment (Table2).

HCVD+ kidneys underutilization remains challenging at our institution and nationwide despite high quality of organs and documented good outcomes. According to Scientific Registry of Transplant Recipients, 2008-2012 data, 6.3% of deceased donor kidney recipients and 2.3% of deceased donors kidneys transplanted were HCV+, hence less than third of HCV+ recipients received HCVD+ kidneys.

With new highly effective DAA therapies, HCVD+ may represent a safe resource to expand the donor pool for HCV+ recipients.

CITATION INFORMATION: Amundsen B, Sise M, Lin M, Deirawan H, Heher E, Kimball B, Markmann J, Elias N. Utilization of HCV-Positive Donors' Kidneys: Potential Benefits in the Era of Direct Acting Antiviral (DAA) Therapy. Am J Transplant. 2016;16 (suppl 3).

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To cite this abstract in AMA style:

Amundsen B, Sise M, Lin M, Deirawan H, Heher E, Kimball B, Markmann J, Elias N. Utilization of HCV-Positive Donors' Kidneys: Potential Benefits in the Era of Direct Acting Antiviral (DAA) Therapy. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/utilization-of-hcv-positive-donors-kidneys-potential-benefits-in-the-era-of-direct-acting-antiviral-daa-therapy/. Accessed March 9, 2021.

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