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Long-term results of kidney transplantation from HCV-positive donors
T Kasprzyk1, A Kwiatkowski, M Wszola
1Department of General and Transplantation Surgery, Medical University of Wroclaw, Wroclaw, Poland. tomekasprzyk@esculap.pl
Insights
Transplanting kidneys from hepatitis C virus (HCV)-positive donors to HCV-positive recipients is safe. This practice improves kidney transplant availability without impacting long-term liver or graft function.
Area of Science:
- Nephrology
- Hepatology
- Transplantation Immunology
Background:
- Organ shortage necessitates using marginal donors, some with hepatitis C virus (HCV).
- HCV infection is a concern in donor-recipient matching for kidney transplantation.
Purpose of the Study:
- To evaluate the outcomes of transplanting kidneys from anti-HCV-positive donors to anti-HCV-positive recipients.
- To assess the impact on liver function, graft survival, and patient survival.
Main Methods:
- Retrospective analysis of 765 kidney transplantations (1994-2006).
- Comparison of HCV(+)/HCV(+) recipients (n=60) with HCV(-)/HCV(+) and HCV(-)/HCV(-) control groups.
- Inclusion of recipient liver function tests, graft, and patient survival data.
Main Results:
- No significant differences in liver function tests (LFTs) or creatinine levels at 5 years.
- Comparable patient survival and graft survival across all groups.
- Similar rates of return to dialysis.
Conclusions:
- Transplanting kidneys from HCV-positive donors to HCV-positive recipients does not adversely affect long-term liver or renal allograft function.
- This strategy increases kidney transplant availability for end-stage renal disease patients.
Background:
Due to the shortage of organs for transplantation, procurement of kidneys from marginal donors is inevitable. Not infrequently, these donors are infected with hepatitis C virus (HCV).
Aim:
We sought to determine the effect of transplanting kidneys from anti-HCV-positive donors to anti-HCV-positive recipients.
Patients And Methods:
Among 765 procedures between 1994 and 2006, 259 kidney recipients were anti-HCV-positive, including 60 who received kidneys from anti-HCV-positive donors (HCV(+)/HCV(+) group) and the others, from seronegative donors (HCV(-)/HCV(+) group). The control group of 506 seronegative recipients received kidneys from seronegative donors (HCV(-)/HCV(-) group). All kidneys from anti-HCV-positive donors were preserved with machine perfusion. We investigated recipient liver function tests (LFTs; alanine aminotrasferase, aspartate aminotransferase; alkaline phosphatase, and bilirubin), graft survival, and patient survival.
Results:
No significant difference was observed between the groups among the biochemistry results (LFTs, creatinine at 5 years). No significant differences, were observed in patient survival, graft survival, or number of patients returning to dialysis.
Conclusion:
Transplantation of kidneys from HCV-positive donors to HCV-positive recipients did not influence long-term liver function, or long-term renal allograft function. This strategy enhances the availability of transplantation as means of end-stage renal disease treatment.
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