Shorter waiting times for hepatitis C virus seropositive recipients of cadaveric renal allografts from hepatitis C virus seropositive donors

Abstract

The use of renal allografts from HCV + donors for HCV + recipients shortens the waiting time for these patients, with no short-term differences in renal and liver function, graft loss, or patient survival.

Donor Hepatitis C Seropositivity

“…In parallel with single-center experience showing reduced time on the transplant waiting list for HCV-positive transplant recipients who received HCV-positive donor kidneys (35), the duration of time on dialysis before transplant for recipients who were hepatitis C-positive was significantly shorter if they received a hepatitis C-positive kidney than if they received a hepatitis C-negative kidney. Categorical vari- ables for the study population are shown in Table 3, with results of univariate analysis and logistic regression for their association with donor hepatitis C-positive kidneys and also with recipients who were negative for hepatitis C who received hepatitis C-positive kidneys.…”

The Evaluation of the Renal Transplant Candidates: Clinical Practice Guidelines

“…What little data exist suggest that there is no increased risk to the recipient in the short term (599, 600), and that waiting times are reduced (599). However, the long-term consequences of transmitting a new HCV strain or co-infecting the recipient with two strains (donor and recipient) are unknown.…”

“…Finally, it has been suggested that HCV-positive transplant candidates may be reasonable recipients for kidneys harvested from HCV-infected organ donors (598,599). What little data exist suggest that there is no increased risk to the recipient in the short term (599, 600), and that waiting times are reduced (599).…”

PHS Guideline for Reducing Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus Transmission through Organ Transplantation

“…The remaining nine studies found no significant difference. 48,56,195,200,201,[203][204][205][206][207][208] Topic This question differs from Question 7 because the donor is not known to be infected but is identified as having an increased probability of infection due to certain behavioral or nonbehavioral characteristics. Two simulation studies met the inclusion criteria 209,210 but made different comparisons; therefore, they were considered separately.…”

“…Additionally, the baseline characteristics between groups differed; donor/recipient ages were older and the recipients' time on the wait list was shorter in HCV-positive donor groups. 201,208 Of the 11 studies that also reported patient survival, one study favored recipients of organs from HCV-negative donors, 196,197 and another study favored recipients of organs from HCVpositive donors 206 (statistical adjustments were applied to control for baseline differences). The remaining nine studies found no significant difference.…”