Hepatitis C positive donor kidney transplants to decrease wait time for kidney recipients: Review of data and recent trials


Hepatitis C positive donor kidney transplants to decrease wait time for kidney recipients: Review of data and recent trials


Amarpreet S Sandhu, DO, MBA, FASN.

Department of Kidney Transplant, California Pacific, Medical Center, San Francisco, CA.


Global Journal of Urology and Nephrology

A kidney transplant is superior to dialysis for patients with end-stage renal disease. The increasing number of end-stage renal disease patients and limited number of available donor kidneys have led to long waiting times to receive a life-saving kidney transplant. Approximately, 14% of the patients wait for more than five years to receive a kidney transplant. The risk of death and becoming too sick to receive a transplant while on the waitlist poses another healthcare challenge. About 21% of the patients are removed from the waitlist every year without receiving a kidney transplant. Over time many strategies are being proposed and used to eliminate the shortage of kidney organs. The advent of the novel therapy for HCV infection and the increasing number of HCV infected donor kidneys due to the unfortunate opioid epidemic has provided new opportunities for kidney recipients. More than 500 high-quality HCV positive donor kidneys are discarded every year. The recent trials of HCV positive donor kidney transplants to HCV negative recipients followed by successful HCV treatment are very motivating. The studies have illustrated that the quality of HCV positive donor kidneys are very similar or even better than HCV negative donor kidneys. HCV positive donor kidney transplants will shorten wait-time for kidney transplant recipients and save lives.


Keywords: HCV infected kidney transplant, HCV positive kidney transplant, Underutilized HCV positive donor kidneys.

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How to cite this article:
Amarpreet S Sandhu. Hepatitis C positive donor kidney transplants to decrease wait time for kidney recipients: Review of data and recent trials. Global Journal of Urology and Nephrology, 2020, 3:20. DOI: 10.28933/gjun-2020-02-1405


References:

1. Organ Procurement and Transplant Network, OPTN Data, August 2019. Optn.tranplant.hrsa.gov/data.
2. Kucirka LM, Singer Al, Ros RL et al. Underutilization of hepatitis C-positive kidneys for hepatitis C-positive recipeints. Am J Transplant. 2010;10:1238-46.
3. Zibbell JE, Asher AK, Patel RC et al. Increases in acute hepatitis C virus infection related to a growing opioid epidemic and associated injection drug use, US, 2004 to 2014. Am J Public Health. 2018;108:175-81,
4. Li AA, Cholankeril G, Cheng XS et al. Underutilization of Hepatitis C virus seropositive donor kidneys in the United States in the current opioid epidemic and Direct-Acting Antiviral Era. Disease. 2018,6,62;doi:10.3390.
5. Pockros PJ et al. Clin Pharmacol Ther. 2014; 95:98.
6. Reese PP, Abt PL, Blumber EA et al. Transplanting hepatitis C-positive kidneys. N Engl J Med. 2015; 373: 303-305.
7. Durand CM, Bowring MG, Bair N, et al. Direct-acting ativiral prophylaxis in kidney transplantation from hepatitis C virus-infected donors to non-infected recipients: an open label non-randomized trial. Ann Intern Med. 2018;168:533-40.
8. Reese PP, Abt PL, Blumber EA, et al. Twelve-month outcomes after transplant of hepatitis C-infected kidneys into uninfected recipients. A single group trial. Ann Inern Med. 2018:169:273-81.
9. OPTN/UNOS Ad Hoc Disease Transmission Advisory Committee, briefing paper on guidance on explaining the risk related to the use of PHS increased risk donor organs when considering organ offers. June 2017.
10. Pereira BJ, Wright TL, Schmid CH, et al. A controlled study of hepatitis C transmission by organ transplantation. The New England Organ Bank Hepatitis C study group. Lancet. 1995;345:484-7.
11. Bixler D, Annambholta P, Abara WE, et al. hepatitis B and C virus infections transmitted through organ transplantation investigated by CDC, United States, 2014-2017. Am J Transplant. 2019; 19(9): 2570–2582.
12. Gupta G, Zhang Y, Carroll N, et al. Cost-effectiveness of hepatitis C-positive donor kidney transplantation for hepatitis C-negative recipients with concomitant direct-acting antiviral therapy. Am J Tranplant. 2018:18:2496-2505.