Kidney graft survival in patients with hepatitis C: a single center experience

Abstract

Hepatitis C virus (HCV) infection is highly prevalent in renal transplant candidates; however, its effect on the transplant outcome is still controversial. The aim of the present study was to determine the effect of HCV infection in the outcome of kidney transplantation in a single transplant center. The study population 144 HCV- randomized selected patients and 64 HCV+ patients transplanted from 1973 to 2000, followed for up to 60 months post-transplantation. This retrospective study included the following variables: type of dialysis, time on renal replacement therapy, number of transfusions before and after transplantation, number of transplants, type of donor, immunosuppression, and rejection episodes. The Kaplan-Meier method was used to estimate graft and patient survival. Log-rank test was used to assess the difference in survival between HCV+ and HCV-. A multivariate Cox proportional hazards model was used to analyze the relation between graft and patient survival. HCV+ and HCV- patients had similar demographic and clinical characteristics; however, a higher number of HCV+ patients received blood transfusions after transplantation. Patient survival was not significantly different in 39 HCV+ and 96 HCV- patients transplanted with living-related donors (71% and 77% at five yr, respectively). Similarly, there was not significant difference in 25 HCV+ and 48 HCV- patients transplanted with kidneys from deceased donors, although there was a tendency to better outcome in HCV- patients (55% and 72% at five yr respectively). Regarding graft survival, there was also no differences in HCV+ and HCV- recipients of living-related grafts (61% and 66% at five yr post-transplant, respectively) and recipients of kidneys from deceased donors (44% and 41%, respectively). The results show that HCV+ patients can be transplanted with the same success than HCV- patients.

A Novel Risk Score for Mortality in Renal Transplant Recipients Beyond the First Posttransplant Year

“…Pretransplant hepatitis C infection was associated with increased risk for mortality in our predictive model. Although the effect of hepatitis C on survival is controversial (13,14), it is possible that differences in the prevalence of this infection or immunosuppressive policies may explain the different impact of hepatitis C after KT. Proteinuria is a noticeable predictor of cardiovascular disease and death in uremic patients, including KT (15).…”

NASPGHAN Practice Guidelines

“…Again, the prevalence is rare. Data in adults suggest that kidney transplant recipients with CHC have similar graft and patient survival outcomes as do recipients who do not have CHC (163). In general, antiviral therapy after renal transplant is not considered a safe option (164).…”