Abstract
SO032THE DISCARD AND DECLINE OF HEPATITIS C VIRUS POSITIVE DONOR KIDNEYS IN THE UNITED STATES
Nephrology, dialysis, transplantation, Vol.35(Supplement_3)
06/01/2020
DOI: 10.1093/ndt/gfaa139.SO032
Abstract
Abstract
Background and Aims
With more transplant centers in the United States are accepting hepatitis C virus infected (HCV+) deceased donor kidneys (dHCV+), the trend of non-utilization and decline of these organs have not been re-examined.
Method
We used data from the national Organ Procurement and Transplantation Network on deceased donor kidneys between Jan 2000 and Dec 2018 in the United States. Kidney non-utilization for HCV+ was defined as a positive donor HCV status and positive hepatitis as the reason for non-utilization. dHCV+ kidney decline was defined as a donor HCV+ status among kidneys recovered for transplantation but not transplanted. We assessed associations of a dHCV+ status with kidney non-utilization or decline, adjusted for donor characteristics (age, race, sex, body mass index, diabetes, hypertension, kidney donor profile index), using multivariable logistic regression.
Results
A total of 274,570 deceased donor kidneys procured for transplantation between 2000 and 2018 were identified. Among these kidneys, 4.1% were from dHCV+. Proportion of dHCV+ non-utilization among all non-utilized kidneys increased from 2000-2005 (3.9%) and then subsequently declined. This proportion increased slightly to 1.1% in 2014 and decreased to 0.5, 0.8, 0.4, 0.6% in 2015-2018, respectively. Multivariable-adjusted odds ratios for dHCV+ non-utilization and decline by year demonstrate consistently an increasing trend from 2000-2006 followed by a decreasing trend from 2006-2011 (Fig A-B). Multivariable-adjusted odds ratios for dHCV+ (compared to dHCV-) non-utilization and decline increased to 6.56 (95% CI 5.30-8.12) and 6.66 (95% CI 5.39-8.24), respectively, in 2012, and decreased to 2.32 (95% CI 2.01-2.69) and 2.28 (95% CI 1.98-2.64), respectively, in 2018.
Conclusion
dHCV+ non-utilization and decline have decreased in the last few years, particularly after 2014. 2018 had a historic lowest odds ratio for non-utilization and decline of dHCV+ organs, which reflects the increased acceptability of transplant centers to these kidneys. Overall, since 2014, the odds ratios for dHCV+ non-utilization and decline decreased by half. Yet, there is more room for decreasing the non-utilization and decline for these potentially life-saving organs.
Details
- Title: Subtitle
- SO032THE DISCARD AND DECLINE OF HEPATITIS C VIRUS POSITIVE DONOR KIDNEYS IN THE UNITED STATES
- Creators
- Tarek Alhamad - Washington University in St. LouisKrista Lentine - Saint Louis UniversityDavid Axelrod - University of IowaSami Abdulnabi - Washington University in St. LouisMark Schnitzler - Saint Louis UniversitySu-Hsin Chang - Washington University in St. Louis
- Resource Type
- Abstract
- Publication Details
- Nephrology, dialysis, transplantation, Vol.35(Supplement_3)
- DOI
- 10.1093/ndt/gfaa139.SO032
- ISSN
- 0931-0509
- eISSN
- 1460-2385
- Language
- English
- Date published
- 06/01/2020
- Academic Unit
- Surgery
- Record Identifier
- 9984322891402771
Metrics
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