The summaries are free for public
use. The Chronic Liver Disease
Foundation will continue to add and
archive summaries of articles deemed
relevant to CLDF by the Board of
Trustees and its Advisors.
Abstract Details
The association of donor hepatitis C virus infection with 3-year kidney transplant outcomes in the era of direct-acting antiviral medications
Am J Transplant. 2023 May;23(5):629-635. doi: 10.1016/j.ajt.2022.11.005. Epub 2023 Jan 12.
1Division of Public Health Sciences, Washington University in St Louis, St Louis, Missouri, USA.
2Division of Public Health Sciences, Washington University in St Louis, St Louis, Missouri, USA; Division of Nephrology, Washington University in St Louis, St Louis, Missouri, USA.
3Department of Surgery, New York University Langone Health, New York, New York, USA.
4Department of Surgery, University of Iowa, Iowa City, Iowa, USA.
5Division of Nephrology, Saint Louis University, St Louis, Missouri, USA.
6Division of Transplant Surgery, Washington University in St Louis, St Louis, Missouri, USA.
7Division of Nephrology, Washington University in St Louis, St Louis, Missouri, USA.
8Division of Nephrology, Virginia Commonwealth University, Richmond, Virginia, USA.
9Division of Nephrology, Washington University in St Louis, St Louis, Missouri, USA. Electronic address: talhamad@wustl.edu.
Abstract
To determine the effect of donor hepatitis C virus (HCV) infection on kidney transplant (KT) outcomes in the era of direct-acting antiviral (DAA) medications, we examined 68,087 HCV-negative KT recipients from a deceased donor between March 2015 and May 2021. A Cox regression analysis was used to estimate adjusted hazard ratios (aHRs) of KT failure, incorporating inverse probability of treatment weighting to control for patient selection to receive an HCV-positive kidney (either nucleic acid amplification test positive [NAT+, n = 2331] or antibody positive (Ab+)/NAT- [n = 1826]) based on recipient characteristics. Compared with kidney from HCV-negative donors, those from Ab+/NAT- (aHR = 0.91; 95% confidence interval [CI], 0.75-1.10) and HCV NAT+ (aHR = 0.89; 95% CI, 0.73-1.08) donors were not associated with an increased risk of KT failure over 3 years after transplant. Moreover, HCV NAT+ kidneys were associated with a higher 1-year estimated glomerular filtration (63.0 vs 61.0 mL/min/1.73 m2, P = .007) and lower risk of delayed graft function (aOR = 0.76; 95% CI, 0.68-0.84) compared with HCV-negative kidneys. Our findings suggest that donor HCV positivity is not associated with an elevated risk of graft failure. The inclusion of donor HCV status in the Kidney Donor Risk Index may no longer be appropriate in contemporary practice.