Oral Abstracts

Abstract

Background: More than 500 kidneys from HCV+ deceased donors are discarded each year, even though direct acting antiviral therapies have cure rates exceeding 95%. We performed a pilot trial of transplanting kidneys from HCV+ donors into HCV-recipients (THINKER; NCT02743897; sponsor: Merck). Methods: HCV-patients aged 40-65 years on dialysis, waitlisted for kidney transplant (KT) with ≤548 days of wait time were approached. A three-step process of education and consent was used pre-enrollment. We performed HCV donor genotyping during allocation, and only used kidneys from genotype 1a or 1b donors. We treated recipients with Grazoprevir/Elbasvir when recipient HCV NAT was detected. Results: From 6/1/16-11/11/16, 43 patients were contacted by phone, 22 (51.1%) attended an in-person educational session, 19 (86.4%) consented for screening, and 15 (78.9%) were enrolled. 10 HCV-patients received HCV+ kidneys (median KDPI: 42, IQR: 34-53); 9 were genotype 1a. Median time from activation in UNET for HCV+ donors and KT was 58 days (range 11-130 days). All 10 patients had detectable HCV RNA on post-op day 3, but were undetectable within 4 weeks of starting HCV therapy.

Targeted Urine Metabolomics for Monitoring Renal Allograft Injury and Immunosuppression in Pediatric Patients

“…These are first observations, should be consolidated with more integrative analysis of multi-omic datasets, and could be further aided by spatial metabolomics. Use of metabolomics for kidney disease outcomes generally could complement diagnostics made using other modalities, including gene expression, cell-free DNA, and proteomics [65][66][67][68][69].…”