Donor Hepatitis C Seropositivity

Bucci, Jay R.; Matsumoto, Cal; Swanson, S. John; Agodoa, Lawrence Y.; Holtzmuller, Kent C.; Peters, Thomas G.; Abbott, Kevin C.

doi:10.1097/01.asn.0000034944.90425.75

Cited by 83 publications

(61 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Its use is not recommended after renal transplantation due to a significant risk of graft loss. [20][21][22][23] Adverse consequences on long-term graft and patient survival related to the presence of HCV infection after kidney [24][25][26][27][28][29] and kidney-pancreas 30 transplantation have been clearly established. Thus, it is imperative that safe and effective therapy for chronic HCV infection be administered prior to renal transplantation.…”

Section: Introductionmentioning

confidence: 99%

Meta‐analysis: interferon for the treatment of chronic hepatitis C in dialysis patients

Fabrizi

Dulai²,

Dixit

et al. 2003

Aliment Pharmacol Ther

145

129

View full text Add to dashboard Cite

SUMMARYBackground: The efficacy of interferon monotherapy in dialysis patients with chronic hepatitis C remains unclear, although a number of small clinical trials have been published addressing this issue. Methods and aims: We evaluated the efficacy and safety of initial interferon monotherapy in dialysis patients with chronic hepatitis C by performing a systematic review of the literature with a meta-analysis of clinical trials. The primary outcome was sustained virological response (as a measure of efficacy); the secondary outcome was drop-out rate (as a measure of tolerability). We used the random effects model of Der Simonian and Laird, with heterogeneity and sensitivity analyses. Results: We have identified 14 clinical trials (269 unique patients); two were controlled studies. The mean overall estimate for sustained virological response (SVR) and drop-out rate was 37% [95% confidence interval (CI) 28-48] and 17% (95% CI 10-28),

show abstract

Section: Introductionmentioning

confidence: 99%

Meta‐analysis: interferon for the treatment of chronic hepatitis C in dialysis patients

Fabrizi

Dulai²,

Dixit

et al. 2003

Aliment Pharmacol Ther

145

129

View full text Add to dashboard Cite

show abstract

“…More than half of DHCV+ kidneys are transplanted in HCV+ recipients in the United States; risk factors associated with DHCV+ kidney transplantation include advanced donor and recipient age, African American race, and the possibility of a high rate of dialysis access complications (1,2,4). In addition, DHCV+ kidneys may be used with substantial variation between or within transplant centers depending on circumstances impossible to capture in reviewing single-or multi-center experiences.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Transplantation with Deceased Donor Hepatitis C-Positive Kidneys on Survival in Wait-Listed Long-term Dialysis Patients

Abbott

Lentine

Bucci

et al. 2004

American Journal of Transplantation

130

View full text Add to dashboard Cite

Whether transplantation of deceased donor kidney allografts from donors with antibodies against hepatitis C virus (HCV) confers a survival advantage compared with remaining on the kidney transplant waiting list is not yet known. We studied 38,270 USRDS Medicare beneficiaries awaiting kidney transplantation who presented with end-stage renal disease from April 1, 1995 to July 31, 2000. Cox regression was used to compare the adjusted hazard ratios for death among recipients of kidneys from deceased donors, and donors with antibodies against hepatitis C (DHCV+), controlling for demographics and comorbidities. In comparison to staying on the waiting list, transplantation from DHCV+ was associated with improved survival among all patients (adjusted hazard ratio for death 0.76, 95% CI 0.60, 0.96). Of patients receiving DHCV+ kidneys, 52% were themselves hepatitis C antibody positive (HCV+), so outcomes associated with use of these grafts may have particular implications for HCV+ transplant candidates. Recommendations for use of DHCV+ kidneys may require analysis of data not currently collected from either dialysis or transplant patients. However, transplantation of DHCV+ kidneys is associated with improved patient survival compared to remaining wait-listed and dialysis dependent.

show abstract

“…Recently published data confirmed that kidneys from donors who were hepatitis C positive (HCVϩ) were associated with an independently increased risk of death in renal transplant recipients regardless of recipient HCV status (1). However, donor hepatitis C seropositivity (DHCVϩ) was not independently associated with mortality when limited to patients with valid information (Centers for Medicare and Medicaid Studies [CMS] Form 2728) on comorbid conditions at the time of dialysis initiation.…”

mentioning

confidence: 99%

Hepatitis C and Renal Transplantation in the Era of Modern Immunosuppression

Abbott¹,

Bucci²,

Matsumoto³

et al. 2003

Journal of the American Society of Nephrology

102

View full text Add to dashboard Cite

Abstract. Kidneys from donors who are positive for hepatitis C virus (DHCVϩ) have recently been identified as an independent risk factor for mortality after renal transplantation. However, it has not been determined whether risk persists after adjustment for baseline cardiac comorbidity or applies in the era of modern immunosuppression. Therefore, a historical cohort study was conducted of US adult cadaveric renal transplant recipients from January 1, 1996, to May 31, 2001 followed until October 31, 2001. A total of 36,956 patients had valid donor and recipient HCV serology. Cox regression analysis was used to model adjusted hazard ratios for mortality and graft loss, respectively, adjusted for other factors, including comorbid conditions from Center for Medicare and Medicaid Studies Form 2728 and previous dialysis access-related complications. It was found that DHCVϩ was independently associated with an increased risk of mortality (adjusted hazard ratio, 2.12, 95% confidence interval, 1.72 to 2.87; P Ͻ 0.001), primarily as a result of infection. Mycophenolate mofetil was associated with improved survival in DHCVϩ patients, primarily related to fewer infectious deaths. Adjusted analyses limited to recipients who were HCVϩ, HCV negative, or age 65 and over, or by use of mycophenolate mofetil confirmed that DHCVϩ was independently associated with mortality in each subgroup. It is concluded that DHCVϩ is independently associated with an increased risk of mortality after renal transplantation adjusted for baseline comorbid conditions in all subgroups. Recipients of DHCVϩ organs should be considered at high risk for excessive immunosuppression.The expected clinical course of hepatitis C infection as it affects organ transplant recipients, as well as the use and effect of kidneys from donors who are positive for hepatitis C, remain controversial topics in renal transplantation. Recently published data confirmed that kidneys from donors who were hepatitis C positive (HCVϩ) were associated with an independently increased risk of death in renal transplant recipients regardless of recipient HCV status (1). However, donor hepatitis C seropositivity (DHCVϩ) was not independently associated with mortality when limited to patients with valid information (Centers for Medicare and Medicaid Studies [CMS] Form 2728) on comorbid conditions at the time of dialysis initiation. This may have been because of the relatively small numbers of transplant recipients for whom complete data were available during the study period or because cardiovascular comorbidity was actually lower in patients who received DHCVϩ kidneys, yet the mortality risk for recipients of DHCVϩ kidneys was still greater than for patients who received DHCVϪ kidneys. Possibly, recipients of DHCVϩ kidneys were sicker to start with and thus had a higher risk of death unrelated to receiving a DHCVϩ kidney. Since that study, there have been substantial changes in maintenance immunosuppression practices in the United States. In particular, recent reports have confirmed tha...

show abstract

Donor Hepatitis C Seropositivity

Cited by 83 publications

References 37 publications

Meta‐analysis: interferon for the treatment of chronic hepatitis C in dialysis patients

Meta‐analysis: interferon for the treatment of chronic hepatitis C in dialysis patients

The Impact of Transplantation with Deceased Donor Hepatitis C-Positive Kidneys on Survival in Wait-Listed Long-term Dialysis Patients

Hepatitis C and Renal Transplantation in the Era of Modern Immunosuppression

Contact Info

Product

Resources

About