| Literature DB >> 30861279 |
Mary G Bowring1, Ashton A Shaffer1,2, Allan B Massie1,2, Andrew Cameron1, Niraj Desai1, Mark Sulkowski3, Jacqueline Garonzik-Wang1,2, Dorry L Segev1,2,4.
Abstract
Several single-center reports of using HCV-viremic organs for HCV-uninfected (HCV-) recipients were recently published. We sought to characterize national utilization of HCV-exposed donors for HCV- recipients (HCV D+/R-) in kidney transplantation (KT) and liver transplantation (LT). Using SRTR data (April 1, 2015-December 2, 2018) and Gini coefficients, we studied center-level clustering of 1193 HCV D+/R- KTs and LTs. HCV-viremic (NAT+) D+/R- KTs increased from 1/month in 2015 to 22/month in 2018 (LTs: 0/month to 12/month). HCV-aviremic (Ab+/NAT-) D+/R- KTs increased from < 1/month in 2015 to 26/month in 2018 (LTs: <1/month to 8/month). HCV- recipients of viremic and aviremic kidneys spent a median (interquartile range [IQR]) of 0.7 (0.2-1.6) and 1.6 (0.4-3.5) years on the waitlist versus 1.8 (0.5-4.0) among HCV D-/R-. HCV- recipients of viremic and aviremic livers had median (IQR) MELD scores of 24 (21-30) and 25 (21-32) at transplantation versus 29 (23-36) among HCV D-/R-. 12 KT and 14 LT centers performed 81% and 76% of all viremic HCV D+/R- transplants; 11 KT and 13 LT centers performed 76% and 69% of all aviremic HCV D+/R- transplants. There have been marked increases in HCV D+/R- transplantation, although few centers are driving this practice; centers should continue to weigh the risks and benefits of HCV D+/R- transplantation.Entities:
Keywords: Organ Procurement and Transplantation Network (OPTN); Scientific Registry for Transplant Recipients (SRTR); clinical research/practice; hepatitis C; infection and infectious agents - viral; infectious disease; kidney transplantation/nephrology; liver transplantation/hepatology
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Year: 2019 PMID： 30861279 PMCID： PMC6658335 DOI： 10.1111/ajt.15355
Source DB: PubMed Journal: Am J Transplant ISSN： 1600-6135 Impact factor: 8.086