[Hepatitis C virus and renal transplantation]

Area of Science:

• Nephrology
• Hepatology
• Transplantation Immunology

Context:

• Liver disease is a significant complication post-renal transplantation (RT).
• Hepatitis C virus (HCV) is the primary driver of liver disease in RT recipients.
• The impact of HCV on patient and graft survival is a critical concern.

Purpose:

• To evaluate the impact of HCV infection on mortality and graft survival after RT.
• To assess the risk associated with using HCV-positive donor kidneys in RT.
• To explore the potential of utilizing HCV-positive donor organs for HCV-infected recipients.

Summary:

• Retrospective studies indicate higher mortality in HCV-positive RT recipients compared to HCV-negative recipients.
• Analysis of large databases (USRDS) reveals an independent increased mortality risk (HR 2.12) for recipients of HCV-positive donor kidneys.
• HCV clearance and long-term outcomes after RT are being investigated, with some patients showing sustained virological response to antiviral therapy.

Impact:

• Findings highlight the increased mortality associated with HCV in RT recipients.
• Suggests a potential strategy of using HCV-positive donor kidneys for HCV-infected recipients, requiring informed consent.
• Emphasizes the need for prospective studies to better understand HCV infection dynamics and long-term outcomes in renal allograft recipients.