The association of donor hepatitis C virus infection with 3-year kidney transplant outcomes in the era of direct-acting antiviral medications

Siobhan Sutcliffe; Mengmeng Ji; Su-Hsin Chang; Darren Stewart; David A. Axelrod; Krista L. Lentine; Jason Wellen; Louai Alrata; Gaurav Gupta; Tarek Alhamad

doi:10.1016/j.ajt.2022.11.005

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The association of donor hepatitis C virus infection with 3-year kidney transplant outcomes in the era of direct-acting antiviral medications

Journal article

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The association of donor hepatitis C virus infection with 3-year kidney transplant outcomes in the era of direct-acting antiviral medications

Siobhan Sutcliffe, Mengmeng Ji, Su-Hsin Chang, Darren Stewart, David A. Axelrod, Krista L. Lentine, Jason Wellen, Louai Alrata, Gaurav Gupta and Tarek Alhamad

American journal of transplantation, Vol.23(5), pp.629-635

05/2023

DOI: 10.1016/j.ajt.2022.11.005

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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.

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Title: Subtitle: The association of donor hepatitis C virus infection with 3-year kidney transplant outcomes in the era of direct-acting antiviral medications
Creators: Siobhan Sutcliffe - Washington University in St. Louis
Mengmeng Ji
Su-Hsin Chang
Darren Stewart
David A. Axelrod
Krista L. Lentine
Jason Wellen
Louai Alrata
Gaurav Gupta
Tarek Alhamad
Resource Type: Journal article
Publication Details: American journal of transplantation, Vol.23(5), pp.629-635
DOI: 10.1016/j.ajt.2022.11.005
ISSN: 1600-6135
eISSN: 1600-6143
Grant note: DOI: 10.13039/100007338, name: Foundation for Barnes-Jewish Hospital
Language: English
Electronic publication date: 12/05/2022
Date published: 05/2023
Academic Unit: Surgery
Record Identifier: 9984359614202771

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