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Updated: Apr 23, 2026

Heterotopic Auxiliary Whole Liver Rat Transplant Model Utilizing a Hepaticoureterostomy for Allograft Rejection Studies
Published on: March 8, 2024
Kidney transplantation threshold in patients with hepatitis C: a decision analysis model
Gina Choi1, Kristina G Lee, Crystal Wu
11 Department of Medicine, University of California, Los Angeles, CA. 2 Department of Surgery, University of California, Los Angeles, CA.
Background:
There are no standard guidelines for the permissible degree of liver fibrosis in patients with chronic hepatitis C virus prohibiting cadaveric renal transplantation (CRT).
Methods:
A decision analysis model was constructed to compare 5-year patient survival using three strategies for patients on hemodialysis. The probabilities of pretransplant and posttransplant survival, progression of liver fibrosis, CRT, and sustained viral response were obtained from a systematic review of the literature. Sensitivity analyses were performed.
Results:
Kidney transplantation was associated with improved 5-year survival for patients with fibrosis stages 1 to 3, but not stage 4 (cirrhosis). Antiviral therapy was associated with improvement in survival in patients with stage 3 fibrosis. The 5-year survival was similar for patients with stage 4 irrespective of the option of antiviral therapy. The model was sensitive to varying the probability of both pretransplant and posttransplant survival.
Conclusion:
There appears to be no overall 5-year survival benefit in treating S1 and S2 fibrosis patients with hepatitis C virus antiviral therapy before CRT. There is no benefit in overall 5-year survival in patients with cirrhosis and thus should not be candidates for CRT.
Related Concept Videos
Kidney Transplant I: Introduction
Kidney Transplant II: Surgical Procedure
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
Kidney Transplant III: Nursing Management
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

