Kidney Transplantation From Hepatitis C Viremic Deceased Donors to Aviremic Recipients in a Real-world Setting
| Autor: | Heidi M. Schaefer, Princess Shelton, J. Harold Helderman, Saed H. Shawar, H. O'Dell, Laura Hickman, Bonnie Ann Sarrell, Scott A. Rega, Roman E. Perri, Guneet Kochar, Jasmine Walker, Kristin Smith, April DeMers, Rachel C. Forbes, Kelly A. Birdwell, David Shaffer, Bernard J. DuBray, Anthony Langone, Beatrice P. Concepcion, Irene D. Feurer, Ruchi Naik, Laura A Binari, Meghan E. Kapp |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Transplantation
Kidney Creatinine medicine.medical_specialty RD1-811 business.industry Renal function Hepatitis C medicine.disease Kidney Transplantation chemistry.chemical_compound medicine.anatomical_structure chemistry Diabetes mellitus Virologic response Internal medicine medicine Surgery business Kidney transplantation |
| Zdroj: | Transplantation Direct Transplantation Direct, Vol 7, Iss 10, p e761 (2021) |
| ISSN: | 2373-8731 |
| Popis: | Background. Transplantation of hepatitis C viremic (HCV+) deceased donor kidney transplants (DDKT) into aviremic (HCV–) recipients is a strategy to increase organ utilization. However, there are concerns around inferior recipient outcomes due to delayed initiation of direct-acting antiviral (DAA) therapy and sustained HCV replication when implemented outside of a research setting. Methods. This was a retrospective single-center matched cohort study of DDKT recipients of HCV+ donors (cases) who were matched 1:1 to recipients of HCV– donors (comparators) by age, gender, race, presence of diabetes, kidney donor profile index, and calculated panel-reactive antibody. Data were analyzed using summary statistics, t-tests, and chi-square tests for between-group comparisons, and linear mixed-effects models for longitudinal data. Results. Each group consisted of 50 recipients with no significant differences in baseline characteristics. The 6-mo longitudinal trajectory of serum creatinine and estimated glomerular filtration rate did not differ between groups. All recipients had similar rates of acute rejection and readmissions (all P > 0.05). One case lost the allograft 151 d posttransplant because of acute rejection, and 1 comparator died on postoperative day 7 from cardiac arrest. HCV+ recipients initiated DAA on average 29 ± 11 d posttransplant. Ninety-eight percent achieved sustained virologic response at 4 and 12 wks with the first course of therapy; 1 patient had persistent HCV infection and was cured with a second course of DAA. Conclusions. Aviremic recipients of HCV+ DDKT with delayed DAA initiation posttransplant had similar short-term outcomes compared with matched recipient comparators of HCV– donors. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|