One-year outcomes of the Multi-center studY to Transplant Hepatitis-C InfeCted kidneys (MYTHIC) Trial

Abstract Introduction Transplanting kidneys from hepatitis C virus (HCV) viremic donors into HCV-negative patients (HCV D-RNA-positive/R-negative) has evolved from experimental to ‘standard-of-care’ at many centers. However, most data derive from single centers and provide only short-term follow-up. Methods The MYTHIC study was a multi-center (7 sites) trial of HCV D-RNA-positive/R-negative kidney transplantation (KT), followed by 8 weeks of glecaprevir/pibrentasvir initiated 2 to 5 days post-KT. Prespecified outcomes included probability of KT (vs. matched waitlist comparators) and 1-year safety outcomes, allograft function, and survival. Results Among 63 enrolled patients, 1-year cumulative incidence of KT was approximately 3.5-fold greater for the MYTHIC cohort versus 2,055 matched UNOS comparators who did not opt-in to receive a kidney from an HCV-viremic donor (68% vs. 19%, p Conclusion One-year findings from this multi-center trial suggest that opting-in for HCV-viremic KT offers can increase probability of KT with excellent 1-year outcomes. Trial Registration: NCT03781726