Transplantation of Kidneys From Hepatitis C Virus–Infected Donors to Hepatitis C Virus–Negative Recipients: One-Year Kidney Allograft Outcomes

Abstract Rationale & Objective Transplant centers in United States are increasingly willing to transplant kidneys from hepatitis C (HCV) infected donors into hepatitis C negative recipients. We studied the association of HCV infected donor status with kidney allograft function and post-transplant allograft biopsy findings. Study Design Retrospective cohort study. Setting & Participants We examined 65 HCV negative recipients who received a kidney from a HCV infected donor (HCV+) and 59 HCV negative recipients who received a kidney from a donor without HCV infection (HCV-) during 2018 at a single transplant center. Exposure(s)/Predictor(s) Donor infection with HCV. Outcome Kidney allograft function and allograft biopsy findings during first year following transplantation. Analytical Approach We compared estimated glomerular filtration rate (eGFR), findings on for-cause and surveillance protocol biopsies, development of de novo donor specific antibodies (DSAs), and patient and allograft outcomes during the first year following transplantation between HCV+ and HCV- recipients. We used linear regression to estimate the independent association between allograft function and HCV viremic status of the kidney donor. Results The mean ±SD age of recipients was 52 ±11 years, 43% were female, 19% and 80% of recipients were White and Black, respectively. Baseline characteristics were similar between the HCV+ and HCV- groups. The delayed graft function rates (12% vs 8%), estimated GFRs post-transplant at 3, 6, 9 and 12 months, proportion of patients with cellular rejection (6% vs 7%), and proportion with antibody mediated rejection (7% vs 10%) or de novo DSAs (31% vs 20%) were not statistically significantly different between the HCV+ and HCV- groups. HCV viremic status was not associated with eGFR at 3, 6, 9 or 12 months. Limitations Generalizability is limited from a single center study and small sample size. Conclusions Recipients of kidneys from donors infected with HCV have similar kidney allograft function and probability of rejection in the first year after transplantation compared to those who received kidneys from donors without HCV infection.