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Introduction: Utilization of hepatitis C viremic (HCV+) deceased donor kidneys (DDKT) for aviremic recipients increases opportunities for transplantation with excellent short‐term outcomes. Our primary aim was to understand longer‐term outcomes, specifically assessing kidney and liver function in the first year posttransplant. Methods: This was a retrospective single‐center study of adult DDKT recipients of HCV+ kidneys (cases) matched 1:1 to recipients of HCV‐ kidneys (comparators). Between‐group outcomes were analyzed using comparisons of means and proportions, survival analysis methods, and multivariable mixed effects models. Results: Sixty‐five cases and 65 comparators had statistically comparable demographic and clinical characteristics. There were no between‐group differences in serum creatinine or estimated glomerular filtration rate at month 12 (p =.662) or in their trajectories over months 1–12 (p >.292). Within the first 60 days, rates of liver function values >3 times upper limit of normal among cases were comparable to comparators for aspartate aminotransferase (AST) (14% vs. 6%, p =.242) and higher for alanine transaminase (ALT) (23% vs. 6%, p =.011). AST declined during the first 8 weeks (p =.005) and stabilized for both groups (p =.406) during the following 10 months. ALT declined during the first 8 weeks (p <.001), continued to decline over months 3–12 (p =.016), and the trajectory was unrelated to antiviral therapy initiation among cases. Conclusions: Aviremic recipients of HCV+ kidneys had comparable kidney outcomes to matched recipients of HCV‐ kidneys. Despite more HCV+ recipients having an elevation in ALT within the first 60 days, ALT values normalized with no identified liver complications attributed to HCV. [ABSTRACT FROM AUTHOR]

Solid organ transplant (SOT) recipients are at high risk for severe coronavirus disease 2019 (COVID‐19). Studies suggest that early intervention with monoclonal antibody (MAB) treatment directed against the SARS‐CoV‐2 spike protein may reduce the risk of emergency department visits or hospitalization for COVID‐19, especially in high‐risk patients. Herein, we describe our single‐center experience of 93 SOT (50 kidney, 17 liver, 11 lung, nine heart, and six dual‐organ) recipients with mild to moderate COVID‐19 who were treated with bamlanivimab or casirivimab‐imdevimab per emergency use authorization guidelines. Median age of recipients was 55 [(Interquartile range) 44–63] years, and 41% were diabetic. Median time from transplant to MAB was 64 (IQR 24–122) months and median time from the onset of COVID‐19 symptoms to the infusion was 6 (IQR 4–7) days. All patients had a minimum 30 days of study follow‐up. The 30‐day hospitalization rate for COVID‐19‐directed therapy was 8.7%. Infusion‐related adverse events were rare and generally mild. Biopsy‐proven organ rejection occurred in two patients, and there were no graft losses or deaths. A comparator group of 72 SOT recipients diagnosed with COVID‐19 who were eligible but did not receive MAB treatment had a higher 30‐day hospitalization rate for COVID‐19‐directed therapy (15.3%), although this difference was not statistically significant, after adjustment for age (Odds Ratio 0.49 [95% Confidence Interval 0.18–1.32], p = 0.16). Our experience suggests that MAB treatment, with respect to the available MAB formulations and circulating viral variants present during our study period, may provide favorable outcomes for mild to moderate COVID‐19 in SOT recipients. [ABSTRACT FROM AUTHOR]