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Elderly recipients of hepatitis C positive renal allografts can quickly develop liver disease

Tanya R Flohr1, Hugo Bonatti, Tjasa Hranjec

  • 1Department of Surgery, University of Virginia Health System, Charlottesville, Virginia 22908-0709, USA. trf7b@virginia.edu

The Journal of Surgical Research
|February 10, 2012
PubMed

Insights

Using Hepatitis C virus (HCV)-positive allografts for elderly kidney transplant recipients (eD+/R-) led to poor survival rates (46%) and increased HCV-related liver disease, highlighting significant risks.

Area of Science:

  • Nephrology
  • Hepatology
  • Transplantation Immunology

Background:

  • Elderly renal transplantation (RT) is a growing field.
  • The use of Hepatitis C virus (HCV)-positive allografts in HCV-negative recipients is an area of ongoing research.
  • Donor-recipient HCV serostatus matching is critical in transplantation.

Purpose of the Study:

  • To evaluate the outcomes of using HCV-positive allografts in elderly HCV-negative renal transplant recipients.
  • To compare survival rates and complications in different donor-recipient HCV serostatus groups.
  • To assess the incidence of HCV infection and liver disease in recipients of HCV-positive allografts.

Main Methods:

  • Retrospective analysis of renal transplant data from January 2003 to April 2009.
  • Categorization of recipients and allografts based on Hepatitis C virus (HCV) status.
  • Median follow-up of 1.5 years (range 0.8-5 years) to assess patient survival and complications.

Main Results:

  • Seven of thirteen HCV-negative elderly recipients of HCV-positive allografts (eD+/R-) developed positive HCV viral load and hepatitis.
  • Patient survival was significantly lower in the eD+/R- group (46%) compared to HCV-negative recipients of HCV-negative allografts (eD-/R-) (85%, P = 0.003).
  • Infections, including sepsis and multi-organ failure, were frequent causes of mortality in the eD+/R- group.

Conclusions:

  • The use of HCV-positive allografts in elderly HCV-negative renal transplant recipients is associated with poor outcomes.
  • Rapid development of HCV-related liver disease and high rates of infection-related morbidity and mortality were observed.
  • Careful consideration of donor-recipient HCV serostatus is crucial for optimizing outcomes in elderly renal transplantation.

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