Impact of Willingness to Accept Hepatitis C Seropositive Kidneys Among Hepatitis C RNA-Positive Waitlisted Patients
| Autor: | John P. McVicar, Chandrasekar Santhanakrishnan, Junichiro Sageshima, Angelo M. de Mattos, Christoph Troppmann, Richard V Perez |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
Kidney Disease Hepatitis c rna Hepacivirus 030230 surgery Kidney Medical and Health Sciences Hepatitis Kidney Failure 0302 clinical medicine Risk Factors Viral Chronic Kidney transplantation Liver Disease Graft Survival virus diseases Hepatitis C Middle Aged Original Clinical Science—General Allografts Survival Rate Infectious Diseases RNA Viral Female 030211 gastroenterology & hepatology medicine.medical_specialty Waiting Lists Chronic Liver Disease and Cirrhosis Renal and urogenital Donor Selection 03 medical and health sciences Hepatitis - C Internal medicine medicine Humans Survival rate Retrospective Studies Transplantation business.industry Retrospective cohort study Organ Transplantation Patient Acceptance of Health Care medicine.disease Kidney Transplantation Transplant Recipients digestive system diseases Emerging Infectious Diseases Good Health and Well Being RNA Kidney Failure Chronic Surgery Graft survival Willingness to accept Digestive Diseases business |
| Zdroj: | Transplantation Transplantation, vol 102, iss 7 |
| ISSN: | 0041-1337 |
| DOI: | 10.1097/tp.0000000000002096 |
| Popis: | BACKGROUND: Kidney transplantation from hepatitis C seropositive (HCV+) donors may benefit hepatitis C RNA-positive (RNA+) candidates, but it is unclear how the willingness to be listed for and accept such kidneys affects waitlist and transplant outcomes. METHODS: In a single-center retrospective analysis, HCV+ transplant candidates (N = 169) listed from March 2004 to February 2015 were evaluated. All RNA+ candidates were offered the option to be listed for HCV+ donors. RNA− candidates were listed only for HCV− donors. RESULTS: Fifty-seven patients (51% of all RNA+ transplant candidates) willing to accept HCV+ donors were listed for both HCV+ and HCV− donor kidneys. During 6-year follow up, 43 (75%) of 57 patients accepting HCV+ versus 19 (35%) of 55 patients not accepting HCV+ received a deceased donor kidney transplant (P < 0.0001). Multivariable analysis demonstrated that willingness to be listed for and accept HCV+ kidneys was associated with receiving deceased donor kidney transplant (P = 0.0016). Fewer patients accepting HCV+ donors (7 [12%] vs 16 [29%]) were removed from the list due to death or deteriorated medical condition (P = 0.0117). Posttransplant patient and graft survival rates were not significantly different. Overall patient survival since the listing (combined waitlist and posttransplant survival) was similar among the groups. CONCLUSIONS: HCV RNA+ candidates had better access to transplantation and similar overall survival before the era of widespread use of direct-acting anti-HCV agents. |
| Databáze: | OpenAIRE |
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