Kidney transplantation (KT) from deceased donors with hepatitis C virus (HCV) into HCV-negative recipients has become more common. However, the risk of complications such as BK polyomavirus (BKPyV) remains unknown. We assembled a retrospective cohort at four centers. We matched recipients of HCV-viremic kidneys to highly similar recipients of HCV-aviremic kidneys on established risk factors for BKPyV. To limit bias, matches were within the same center. The primary outcome was BKPyV viremia ≥1000 copies/ml or biopsy-proven BKPyV nephropathy; a secondary outcome was BKPyV viremia ≥10 000 copies/ml or nephropathy. Outcomes were analyzed using weighted and stratified Cox regression. The median days to peak BKPyV viremia level was 119 (IQR 87-182). HCV-viremic KT was not associated with increased risk of the primary BKPyV outcome (HR 1.26, p = .22), but was significantly associated with the secondary outcome of BKPyV ≥10 000 copies/ml (HR 1.69, p = .03). One-year eGFR was similar between the matched groups. Only one HCV-viremic kidney recipient had primary graft loss. In summary, HCV-viremic KT was not significantly associated with the primary outcome of BKPyV viremia, but the data suggested that donor HCV might elevate the risk of more severe BKPyV viremia ≥10 000 copies/ml. Nonetheless, one-year graft function for HCV-viremic recipients was reassuring.© 2021 The American Society of Transplantation and the American Society of Transplant Surgeons.
About The Expert
Miklos Z Molnar
Vishnu S Potluri
Douglas E Schaubel
Meghan E Sise
Beatrice P Concepcion
Rachel C Forbes
Emily Blumberg
Roy D Bloom
David Shaffer
Raymond T Chung
Ian A Strohbehn
Nahel Elias
Ambreen Azhar
Mital Shah
Deirdre Sawinski
Laura A Binari
Manish Talwar
Vasanthi Balaraman
Anshul Bhalla
James D Eason
Behdad Besharatian
Jennifer Trofe-Clark
David S Goldberg
Peter P Reese
References
PubMed