Twelve-month kidney and liver outcomes of kidney transplantation from Hepatitis C Viremic deceased donors to aviremic recipients
© 2023 Wiley Periodicals LLC..
INTRODUCTION: Utilization of hepatitis C viremic (HCV+) deceased donor kidneys (DDKT) for aviremic recipients increases opportunities for transplantation with excellent short-term outcomes. Our primary aim was to understand longer-term outcomes, specifically assessing kidney and liver function in the first year posttransplant.
METHODS: This was a retrospective single-center study of adult DDKT recipients of HCV+ kidneys (cases) matched 1:1 to recipients of HCV- kidneys (comparators). Between-group outcomes were analyzed using comparisons of means and proportions, survival analysis methods, and multivariable mixed effects models.
RESULTS: Sixty-five cases and 65 comparators had statistically comparable demographic and clinical characteristics. There were no between-group differences in serum creatinine or estimated glomerular filtration rate at month 12 (p = .662) or in their trajectories over months 1-12 (p > .292). Within the first 60 days, rates of liver function values >3 times upper limit of normal among cases were comparable to comparators for aspartate aminotransferase (AST) (14% vs. 6%, p = .242) and higher for alanine transaminase (ALT) (23% vs. 6%, p = .011). AST declined during the first 8 weeks (p = .005) and stabilized for both groups (p = .406) during the following 10 months. ALT declined during the first 8 weeks (p < .001), continued to decline over months 3-12 (p = .016), and the trajectory was unrelated to antiviral therapy initiation among cases.
CONCLUSIONS: Aviremic recipients of HCV+ kidneys had comparable kidney outcomes to matched recipients of HCV- kidneys. Despite more HCV+ recipients having an elevation in ALT within the first 60 days, ALT values normalized with no identified liver complications attributed to HCV.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:26 |
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| Enthalten in: |
Transplant infectious disease : an official journal of the Transplantation Society - 26(2024), 1 vom: 06. Feb., Seite e14213 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Binari, Laura A [VerfasserIn] |
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| Links: |
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| Themen: |
Antiviral Agents |
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| Anmerkungen: |
Date Completed 16.02.2024 Date Revised 09.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/tid.14213 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM366027786 |
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| 100 | 1 | |a Binari, Laura A |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Twelve-month kidney and liver outcomes of kidney transplantation from Hepatitis C Viremic deceased donors to aviremic recipients |
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| 500 | |a Date Revised 09.03.2024 | ||
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| 520 | |a © 2023 Wiley Periodicals LLC. | ||
| 520 | |a INTRODUCTION: Utilization of hepatitis C viremic (HCV+) deceased donor kidneys (DDKT) for aviremic recipients increases opportunities for transplantation with excellent short-term outcomes. Our primary aim was to understand longer-term outcomes, specifically assessing kidney and liver function in the first year posttransplant | ||
| 520 | |a METHODS: This was a retrospective single-center study of adult DDKT recipients of HCV+ kidneys (cases) matched 1:1 to recipients of HCV- kidneys (comparators). Between-group outcomes were analyzed using comparisons of means and proportions, survival analysis methods, and multivariable mixed effects models | ||
| 520 | |a RESULTS: Sixty-five cases and 65 comparators had statistically comparable demographic and clinical characteristics. There were no between-group differences in serum creatinine or estimated glomerular filtration rate at month 12 (p = .662) or in their trajectories over months 1-12 (p > .292). Within the first 60 days, rates of liver function values >3 times upper limit of normal among cases were comparable to comparators for aspartate aminotransferase (AST) (14% vs. 6%, p = .242) and higher for alanine transaminase (ALT) (23% vs. 6%, p = .011). AST declined during the first 8 weeks (p = .005) and stabilized for both groups (p = .406) during the following 10 months. ALT declined during the first 8 weeks (p < .001), continued to decline over months 3-12 (p = .016), and the trajectory was unrelated to antiviral therapy initiation among cases | ||
| 520 | |a CONCLUSIONS: Aviremic recipients of HCV+ kidneys had comparable kidney outcomes to matched recipients of HCV- kidneys. Despite more HCV+ recipients having an elevation in ALT within the first 60 days, ALT values normalized with no identified liver complications attributed to HCV | ||
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| 650 | 4 | |a hepatitis C | |
| 650 | 4 | |a kidney transplant | |
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| 700 | 1 | |a Thorne, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Rega, Scott A |e verfasserin |4 aut | |
| 700 | 1 | |a Feurer, Irene D |e verfasserin |4 aut | |
| 700 | 1 | |a Shawar, Saed |e verfasserin |4 aut | |
| 700 | 1 | |a Naik, Ruchi |e verfasserin |4 aut | |
| 700 | 1 | |a Birdwell, Kelly A |e verfasserin |4 aut | |
| 700 | 1 | |a Helderman, J Harold |e verfasserin |4 aut | |
| 700 | 1 | |a Langone, Anthony |e verfasserin |4 aut | |
| 700 | 1 | |a Sarrell, Bonnie Ann |e verfasserin |4 aut | |
| 700 | 1 | |a Schaefer, Heidi |e verfasserin |4 aut | |
| 700 | 1 | |a DuBray, Bernard John |e verfasserin |4 aut | |
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| 700 | 1 | |a Hickman, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Shaffer, David |e verfasserin |4 aut | |
| 700 | 1 | |a Concepcion, Beatrice P |e verfasserin |4 aut | |
| 700 | 1 | |a Forbes, Rachel C |e verfasserin |4 aut | |
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