Journal article
Trends in Discard of Kidneys from Hepatitis C Viremic Donors in the United States
Clinical journal of the American Society of Nephrology, Vol.16(2), pp.251-261
02/08/2021
DOI: 10.2215/CJN.10960720
PMCID: PMC7863640
PMID: 33451990
Abstract
Kidneys from hepatitis C virus (HCV) viremic donors have become more commonly accepted for transplant, especially after effective direct-acting antiviral therapy became available in 2014. We examined the contemporary trend of kidney discard from donors with HCV seropositivity and viremia.
Data from the Organ Procurement and Transplantation Network were used to identify deceased donor kidneys recovered for transplant. The exposure was donor HCV antibody status in the first analyses, and donor HCV antibody and viremia status in the second analyses. Multilevel, multivariable logistic regression was used to assess the association of these HCV exposure measures with kidney discard, adjusted for donor characteristics. Multilevel analyses were conducted to account for similar kidney discard pattern within clusters of organ procurement organizations and regions.
Among 225,479 kidneys recovered from 2005 to 2019, 5% were from HCV seropositive donors. Compared with HCV seronegative kidneys, the odds of HCV seropositive kidney discard gradually declined, from a multivariable-adjusted odds ratio (aOR) of 7.06 (95% confidence interval [95% CI], 5.65 to 8.81) in 2014, to 1.20 (95% CI, 1.02 to 1.42) in 2019. Among 82,090 kidneys with nucleic acid amplification test results in 2015-2019, 4% were from HCV viremic donors and 2% were from aviremic seropositive donors. Compared with HCV aviremic seronegative kidneys, the odds of HCV viremic kidney discard decreased from an aOR of 4.89 (95% CI, 4.03 to 5.92) in 2018, to 1.48 (95% CI, 1.22 to 1.81) in 2019. By 2018 and 2019, aviremic seropositive status was not associated with higher odds of discard (2018: aOR, 1.13; 95% CI, 0.88 to 1.45; and 2019: aOR, 0.97; 95% CI, 0.76 to 1.23).
Despite the decrease in kidney discard in recent years, kidneys from viremic (compared with aviremic seronegative) donors still had 48% higher odds of discard in 2019. The potential of these discarded organs to provide successful transplantation should be explored.
Details
- Title: Subtitle
- Trends in Discard of Kidneys from Hepatitis C Viremic Donors in the United States
- Creators
- Su-Hsin Chang - Washington University in St. LouisMassini Merzkani - Washington University in St. LouisKrista L Lentine - Center for Abdominal Transplantation, Saint Louis University School of Medicine, St. Louis, MissouriMei Wang - Washington University in St. LouisDavid A Axelrod - University of IowaSiddiq Anwar - Division of Nephrology, Seha Kidney Care, Abu Dhabi, United Arab Emirates.Mark A Schnitzler - Saint Louis UniversityJason Wellen - Washington University in St. LouisWilliam C Chapman - Washington University in St. LouisTarek Alhamad - Washington University in St. Louis
- Resource Type
- Journal article
- Publication Details
- Clinical journal of the American Society of Nephrology, Vol.16(2), pp.251-261
- DOI
- 10.2215/CJN.10960720
- PMID
- 33451990
- PMCID
- PMC7863640
- ISSN
- 1555-9041
- eISSN
- 1555-905X
- Grant note
- name: Mid-America Transplant, award: 032018; name: Foundation of Barnes Jewish Hospital, award: 4746; name: Mid-America Transplant
- Language
- English
- Date published
- 02/08/2021
- Academic Unit
- Surgery
- Record Identifier
- 9984322930202771
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