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Long term Outcomes and Transmission Rates in Hepatitis C Virus Positive Donor to Hepatitis C Virus Negative Kidney Transplant Recipients: Analysis of United States National Data.

Long term Outcomes and Transmission Rates in Hepatitis C Virus Positive Donor to Hepatitis C Virus Negative Kidney Transplant Recipients: Analysis of United States National Data.
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Gupta G, Kang L, Yu JW, Limkemann AJ, Garcia V, Bandyopadhyay D, Kumar D, Fattah H, Levy M, Cotterell AH, Sharma A, Bhati CS, Reichman T, King AL, Sterling RK,


Gupta G, Kang L, Yu JW, Limkemann AJ, Garcia V, Bandyopadhyay D, Kumar D, Fattah H, Levy M, Cotterell AH, Sharma A, Bhati CS, Reichman T, King AL, Sterling RK, (click to view)

Gupta G, Kang L, Yu JW, Limkemann AJ, Garcia V, Bandyopadhyay D, Kumar D, Fattah H, Levy M, Cotterell AH, Sharma A, Bhati CS, Reichman T, King AL, Sterling RK,

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Clinical transplantation 2017 07 16() doi 10.1111/ctr.13055
Abstract

The use of kidneys from hepatitis C virus (HCV) positive (D+) deceased donors for HCV negative recipients (R-) might increase the donor pool. We analyzed the national OPTN registry from 1994-2014 to compare the outcomes of HCV D+/R- (n=421) to propensity matched HCV donor negative (D-)/R- kidney transplants, as well as with, wait listed patients who never received a transplant, in a 1:5 ratio (n = 2105, per matched group). Both 5-year graft (44% vs. 66%; p < 0.001) and patient survival (57% vs. 79%; p < 0.001) were inferior for D+/R- group compared to D-/R-. Nevertheless, five-year patient survival from the time of wait listing was superior for D+/R- when compared to wait listed controls (68% vs. 43%; p<0.001). Of the 126 D+/R- with available post-transplant HCV testing, HCV seroconversion was confirmed in 62 (49%), likely donor-derived. Five-year outcomes were similar between D+/R- that seroconverted vs. D+/R- that did not (n = 64). Our analysis shows inferior outcomes for D+/R- patients although detailed data on pre-transplant risk factors was not available. Limited data suggests that HCV transmission occurred in half of HCV D+/R- patients, although this might not have been the primary factor contributing to the poor observed outcomes. This article is protected by copyright. All rights reserved.

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