Effect of kidney donor hepatitis C virus serostatus on renal transplant recipient and allograft outcomes.

BACKGROUND

Hepatitis C virus (HCV) infection is common in dialysis patients and renal transplant recipients and has been associated with diminished patient and allograft survival. HCV-positive (HCV+) kidneys have been used in HCV-positive (HCV+) recipients as a means of facilitating transplantation and expanding the organ donor pool; however, the effect of donor HCV serostatus in the modern era is unknown.

METHODS

Using national transplant registry data, we created a propensity score-matched cohort of HCV+ recipients who received HCV-positive donor kidneys compared to those transplanted with HCV-negative kidneys.

RESULTS

Transplantation with an HCV+ kidney was associated with an increased risk of death {hazard ratio [HR] 1.43 [95% confidence interval (CI) 1.18-1.76]; P < 0.001} and allograft loss [HR 1.39 (95% CI 1.16-1.67); P < 0.001] compared with their propensity score-matched counterparts. However, HCV+ kidneys were not associated with an increased risk of acute rejection [odds ratio 1.16 (95% CI 0.84-1.61); P = 0.35].

CONCLUSIONS

While use of HCV+ donor kidneys can shorten the wait for renal transplantation and maximize organ utility for all candidates on the waiting list, potential recipients should be counseled about the increased risks associated with HCV+ kidney.