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National Trends in Utilization and 1-Year Outcomes with Transplantation of HCV-Viremic Kidneys.
- Source :
-
Journal of the American Society of Nephrology : JASN [J Am Soc Nephrol] 2019 Oct; Vol. 30 (10), pp. 1939-1951. Date of Electronic Publication: 2019 Sep 12. - Publication Year :
- 2019
-
Abstract
- Background: Recent pilot trials have demonstrated the safety of transplanting HCV-viremic kidneys into HCV-seronegative recipients. However, it remains unclear if allograft function is impacted by donor HCV-viremia or recipient HCV-serostatus.<br />Methods: We used national United States registry data to examine trends in HCV-viremic kidney use between 4/1/2015 and 3/31/2019. We applied advanced matching methods to compare eGFR for similar kidneys transplanted into highly similar recipients of kidney transplants.<br />Results: Over time, HCV-seronegative recipients received a rising proportion of HCV-viremic kidneys. During the first quarter of 2019, 200 HCV-viremic kidneys were transplanted into HCV-seronegative recipients, versus 69 into HCV-seropositive recipients, while 105 HCV-viremic kidneys were discarded. The probability of HCV-viremic kidney discard has declined over time. Kidney transplant candidates willing to accept a HCV-seropositive kidney increased from 2936 to 16,809 from during this time period. When transplanted into HCV-seronegative recipients, HCV-viremic kidneys matched to HCV-non-viremic kidneys on predictors of organ quality, except HCV, had similar 1-year eGFR (66.3 versus 67.1 ml/min per 1.73 m <superscript>2</superscript> , P =0.86). This was despite the much worse kidney donor profile index scores assigned to the HCV-viremic kidneys. Recipient HCV-serostatus was not associated with a clinically meaningful difference in 1-year eGFR (66.5 versus 71.1 ml/min per 1.73 m <superscript>2</superscript> , P =0.056) after transplantation of HCV-viremic kidneys.<br />Conclusions: By 2019, HCV-seronegative patients received the majority of kidneys transplanted from HCV-viremic donors. Widely used organ quality scores underestimated the quality of HCV-viremic kidneys based on 1-year allograft function. Recipient HCV-serostatus was also not associated with worse short-term allograft function using HCV-viremic kidneys.<br /> (Copyright © 2019 by the American Society of Nephrology.)
- Subjects :
- Adult
Aged
Female
Humans
Male
Middle Aged
Retrospective Studies
Time Factors
Tissue Donors
Tissue and Organ Procurement standards
Treatment Outcome
United States
Hepatitis C
Kidney Transplantation statistics & numerical data
Procedures and Techniques Utilization statistics & numerical data
Procedures and Techniques Utilization trends
Tissue and Organ Procurement methods
Viremia
Subjects
Details
- Language :
- English
- ISSN :
- 1533-3450
- Volume :
- 30
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Journal of the American Society of Nephrology : JASN
- Publication Type :
- Academic Journal
- Accession number :
- 31515244
- Full Text :
- https://doi.org/10.1681/ASN.2019050462