COMMENTARY

Can HCV+ Kidneys Safely Go to HCV+ Recipients?

Ron Shapiro, MD

Disclosures

January 20, 2011

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Hi. My name is Ron Shapiro. I am a transplant surgeon at the University of Pittsburgh. Today I want to talk about a recent study that provides long-term outcomes in organ recipients who were hepatitis C-positive and received organs from either hepatitis C-positive donors or hepatitis C-negative donors.

This study from Spain[1] has been published with shorter follow-ups than in the past, and this is the most recent study, now with 5- and 10-year outcomes. Patient survival was unchanged, according to the donor hepatitis C serology. Graft survival at 10 years was inferior in the hepatitis C-positive-to-positive group, but the demographics were different in that both the donors and the recipients were older in the positive-to-positive group, and this could explain a great deal of the inferior 10-year outcomes. When a multivariate analysis was performed, hepatitis C serology was not a significant factor.

This study has, in the past, provided us with some reassurance that for hepatitis C-positive recipients, it did not matter whether the donor was positive or negative. We have been able to use these kidneys in hepatitis C-positive recipients. The study now provides 10-year data confirming the safety of this approach.

One of the holes in this study is that the subtypes of hepatitis C were never characterized, and the serologies in the Spanish donors have generally been related to a single subgroup. However, it is reassuring to know that with long-term follow-up, hepatitis C-positive kidneys can be used in hepatitis C-positive recipients.

Thank you.

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