Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb 23;12(5):1773.
doi: 10.3390/jcm12051773.

Outcome of Kidney Transplants from Viremic and Non-Viremic Hepatitis C Virus Positive Donors into Negative Recipients: Results of the Spanish Registry

Antonio Franco  1 , Francesc Moreso  2 , Eulàlia Solà-Porta  3 , Isabel Beneyto  4 , Núria Esforzado  5 , Francisco Gonzalez-Roncero  6 , Asunción Sancho  7 , Edoardo Melilli  8 , Juan Carlos Ruiz  9 , Cristina Galeano  10 ; Renal Transplantation with HCV Positive Donors Spanish Study Group
Affiliations

Outcome of Kidney Transplants from Viremic and Non-Viremic Hepatitis C Virus Positive Donors into Negative Recipients: Results of the Spanish Registry

Antonio Franco et al. J Clin Med. .

Abstract

Historically, donor infection with hepatitis-C virus (HCV) has been a barrier to kidney transplantation. However, in recent years, it has been reported that HCV positive kidney donors transplanted into HCV negative recipients offer acceptable mid-term results. However, acceptance of HCV donors, especially viremic, has not broadened in the clinical practice. This is an observational, multicenter, retrospective study including kidney transplants from HCV positive donors into negative recipients reported to the Spanish group from 2013 to 2021. Recipients from viremic donors received peri-transplant treatment with direct antiviral agents (DAA) for 8-12 weeks. We included 75 recipients from 44 HCV non-viremic donors and 41 from 25 HCV viremic donors. Primary non function, delayed graft function, acute rejection rate, renal function at the end of follow up, and patient and graft survival were not different between groups. Viral replication was not detected in recipients from non-viremic donors. Recipient treatment with DAA started pre-transplant avoids (n = 21) or attenuates (n = 5) viral replication but leads to non-different outcomes to post-transplant treatment with DAA (n = 15). HCV seroconversion was more frequent in recipients from viremic donors (73% vs. 16%, p < 0.001). One recipient of a viremic donor died due to hepatocellular carcinoma at 38 months. Donor HCV viremia seems not to be a risk factor for kidney transplant recipients receiving peri-transplant DAA, but continuous surveillance should be advised.

Keywords: graft outcome; hepatitis C virus; hepatocellular carcinoma; kidney transplantation; viremic donor.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Patient (left) and graft survival including patients’ death (right) in recipients from non-viremic and viremic donors. p-value were non-significant by Kaplan–Meier analysis (p = 0.415 and p = 0.741, respectively).
Figure 2
Figure 2
Patient (left) and graft survival including patients’ death (right) in recipients from non-viremic and viremic donors either starting DAA treatment pre-transplant or post-transplant. p-values were non-significant by Kaplan–Meier analysis (p = 0.614 and p = 0.768, respectively).
Figure 3
Figure 3
Box plot of the evolution of liver enzymes (AST (left) and ALT (right)) in patients receiving grafts from non-viremic donors (n = 75) and viremic donors either starting DAA treatment before (n = 26) or after transplantation (n = 15). p-values by Kruskal–Wallis test are depicted at the bottom of the figure.
See this image and copyright information in PMC

References

    1. Gastaminza P., Dryden K.A., Boyd B., Wood M.R., Law M., Yeager M., Chisari F.V. Ultrastructural and biophysical characterization of hepatitis C virus particles produced in cell culture. J. Virol. 2010;84:10999–11009. doi: 10.1128/JVI.00526-10. - DOI - PMC - PubMed
    1. Pereira B.J., Milford E.L., Kirkman R.L., Quan S., Sayre K.R., Johnson P.J., Wilber J.C., Levey A.S. Prevalence of hepatitis C virus RNA in organ donors positive for hepatitis C antibody and in the recipients of their organs. N. Engl. J. Med. 1992;327:910–915. doi: 10.1056/NEJM199209243271302. - DOI - PubMed
    1. Levitsky J., Formica R.N., Bloom R.D., Charlton M., Curry M., Friedewald J., Friedman J., Goldberg D., Hall S., Ison M., et al. The American Society of Transplantation Consensus Conference on the Use of Hepatitis C Viremic Donors in Solid Organ Transplantation. Am. J. Transplant. 2017;17:2790–2802. doi: 10.1111/ajt.14381. - DOI - PubMed
    1. Daloul R., Pesavento T.E., Goldberg D.S., Reese P.P. A review of kidney transplantation from HCV-viremic donors into HCV-negative recipients. Kidney Int. 2021;100:1190–1198. doi: 10.1016/j.kint.2021.06.034. - DOI - PubMed
    1. Fabrizi F., Cerutti R., Alfieri C.M., Messa P. Updated View on Kidney Transplant from HCV-Infected Donors and DAAs. Pharmaceutics. 2021;13:496. doi: 10.3390/pharmaceutics13040496. - DOI - PMC - PubMed