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Updated: Apr 18, 2026
Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
Equal 3-Year Outcomes for Kidney Transplantation Alone in HCV-Positive Patients With Cirrhosis
Afshin Parsikia1, Stalin Campos, Kamran Khanmoradi
11 Department of Transplant Surgery, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA.
Insights
Kidney transplantation alone is safe for hepatitis C virus-positive (HCV(+)) patients with compensated cirrhosis. This study shows comparable survival rates, challenging current guidelines.
Area of Science:
- Nephrology
- Hepatology
- Transplantation immunology
Background:
- Cirrhosis is a contraindication for kidney transplantation alone per current guidelines.
- Limited data exists on kidney transplantation alone in clinically compensated cirrhotic patients.
Purpose of the Study:
- To evaluate the safety and viability of kidney transplantation alone in hepatitis C virus-positive (HCV(+)) patients with compensated cirrhosis.
- To compare outcomes between HCV(+) patients with and without cirrhosis undergoing kidney transplantation.
Main Methods:
- Retrospective study comparing outcomes in HCV(+) kidney transplant recipients with and without cirrhosis.
- Kaplan-Meier survival analysis for patient and graft survival over a minimum 3-year follow-up period.
Main Results:
- One- and three-year patient survival rates were 91% and 82% for non-cirrhotic patients, versus 100% and 83% for cirrhotic patients (P = NS).
- One- and three-year graft survival rates (censored for death) were 94% and 81% (non-cirrhotic) versus 95% and 82% (cirrhotic) (P = NS).
- Comparable survival rates were observed between groups, including when analyzing standard kidney allograft recipients separately.
Conclusions:
- Kidney transplantation alone is a safe and viable practice for clinically compensated HCV(+) patients with cirrhosis.
- Findings challenge existing contraindications and support expanded eligibility criteria for kidney transplantation.
Abstract:
Kidney transplantation alone in clinically compensated patients with cirrhosis is not well documented. Current guidelines list cirrhosis as a contraindication for kidney transplantation alone. This is an Institutional Review Board-approved retrospective study. We report our experience with a retrospective comparison between transplants in hepatitis C virus-positive (HCV(+)) patients without cirrhosis and HCV(+) patients with cirrhosis. All of the patients were followed for at least a full 3-year period. All of the deaths and graft losses were recorded and analyzed using Kaplan-Meier methodology. One- and three-year cumulative patient survival rates for noncirrhotic patients were 91% and 82%, respectively. For cirrhotic patients, one- and three-year cumulative patient survival rates were 100% and 83%, respectively (P = NS). One- and three-year cumulative graft survival rates censored for death were 94% and 81%, and 95% and 82% for the noncirrhosis and cirrhosis groups, respectively (P = NS). Comparable patient and allograft survival rates were observed when standard kidney allograft recipients were analyzed separately. This study is the longest follow-up document in the literature showing that HCV(+) clinically ompensated patients with cirrhosis may undergo kidney transplantation alone as a safe and viable practice.
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01:26Kidney Transplant II: Surgical Procedure
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