Name: Clinical Outcomes for Recipients of Kidney Transplantation from Hepatitis C Virus-Infected Donors
Start: 2025-04-24T11:40:00-0400
End: 2025-04-24T11:55:00-0400

You will be able to validate your attendance (Check-In to sessions) using your personal schedule.

Thursday April 24, 2025 11:40am - 11:55am EDT

Athena J

Title: Clinical Outcomes for Recipients of Kidney Transplantation from Hepatitis C Virus-Infected Donors
Authors: Caitlyn Tyus, Sally Sikes, Caroline Gatzke, Victoria Burnette
Objective: To assess allograft survival status at one year post-transplant for recipients of Hepatitis C Virus (HCV) NAT-positive donor kidneys in comparison to those who received kidneys from NAT-negative donors
Self Assessment Question: Does receiving a kidney from an HCV NAT-positive donor affect allograft survival status at one year post-transplant compared to HCV NAT-negative donor kidney recipients?
Background: According to the Organ Procurement and Transplantation Network, over 86% of individuals currently awaiting organ transplantation are specifically in need of a kidney. Despite this high demand, a significant number of potentially life-saving organs have been discarded due to donor Hepatitis C virus (HCV) infection. Since the introduction of direct-acting antivirals (DAAs) in 2014, these treatments have demonstrated to be both safe and effective for managing HCV in patients with chronic kidney disease (CKD) and kidney transplant recipients. Nonetheless, kidneys from HCV-positive donors still faced a 48% increased risk of discard in 2019.
Methods: This study was a single-center retrospective chart review conducted at Ascension Saint Thomas Hospital West (ASTHW) to compare clinical outcomes of deceased-donor kidney transplants from HCV-infected donors versus donors without HCV. The study included patients who received a deceased-donor kidney transplant at ASTHW between November 11, 2020 - October 18, 2023. Patients were included when the following criteria was met: kidney transplant recipient, age ≥18 years at time of transplant. Exclusion criteria included patients with a history of transplant, documentation of dual-organ transplant, pregnant individuals, and incarcerated patients. The primary outcome was the allograft survival status at one year post-transplant for recipients of NAT-positive donor kidneys in comparison to those who received kidneys from NAT-negative donors. Secondary outcomes included incidence of HCV following transplant, rate of HCV recurrence following DAA therapy, and the utilization of various HCV treatment regimens.
Results: In total, 350 patients were screened, with 91 meeting inclusion criteria, and 84 available for follow-up at one year post-transplant (42 in the HCV Donor Positive (POS) group and 42 in the HCV Donor Negative (NEG) group). There was no significant difference in allograft survival status at one year post-transplant between groups (p=0.457). Secondary outcomes conveyed that 64% of patients who received HCV NAT(+) kidneys actually contracted HCV following organ transplantation. The HCV treatment of choice was sofosbuvir-velpatasvir, with glecaprevir-pibrentasvir being utilized in two patients due to the drug interaction between sofosbuvir-velpatasvir and amiodarone. Clearance of HCV was achieved by 85% of patients following initial therapy, two patients (7.5%) reported HCV breakthrough following clearance, one patient (3.7%) experienced treatment failure, and one patient expired during HCV treatment (unrelated to HCV or treatment). The HCV treatment failure was determined to be caused by medication noncompliance. One of the HCV breakthroughs following clearance patients was due to medication noncompliance, while the other was due to the drug interaction and administration timing between sofosbuvir-velpatasvir and magnesium oxide. The secondary treatment following breakthrough or failure was sofosbuvir-velpatasvir-voxilaprevir.
Conclusion: In this study, there was no significant difference in allograft survival between HCV-positive and HCV-negative donor kidney transplant recipients. Interestingly, 36% of patients who received HCV NAT-positive donor kidneys did not contract HCV or require DAA therapy following transplantation; this result was correlated with donor kidneys with HCV NAT-positive but HCV antibody negative results. Limitations of this study included small sample size and inability to represent other HCV treatment regimens. Utilizing HCV-positive donor

Moderators