Miklos Z Molnar1, Ambreen Azhar2, Makoto Tsujita2, Manish Talwar2, Vasanthi Balaraman2, Anshul Bhalla2, Pradeep S B Podila3, Jiten Kothadia2, Uchenna A Agbim4, Benedict Maliakkal2, Sanjaya K Satapathy5, Csaba P Kovesdy6, Satheesh Nair2, James D Eason2. 1. Division of Nephrology & Hypertension, Department of Medicine, University of Utah, Salt Lake City, UT. Electronic address: miklos.molnar@hsc.utah.edu. 2. James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN; Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN. 3. Faith and Health Division, Methodist Le Bonheur Healthcare, Memphis, TN; Division of Health Systems Management and Policy, School of Public Health, The University of Memphis, Memphis, TN. 4. Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN. 5. Department of Medicine, Sandra Atlas Bass Center for Liver Diseases and Transplantation, Zucker School of Medicine at Hofstra University, Northshore University Hospital/Northwell Health, Manhasset, NY. 6. Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN; Nephrology Section, Memphis Veterans' Affairs Medical Center, Memphis, TN.
Abstract
RATIONALE & OBJECTIVE: Transplant centers in the United States are increasingly willing to transplant kidneys from hepatitis C virus (HCV)-infected (HCV+) donors into HCV- recipients. We studied the association between donor HCV infection status and kidney allograft function and posttransplantation allograft biopsy findings. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: We examined 65 HCV- recipients who received a kidney from a HCV+ donor and 59 HCV- recipients who received a kidney from a HCV- donor during 2018 at a single transplant center. EXPOSURE: Predictor(s) of donor infection with HCV. OUTCOMES: Kidney allograft function and allograft biopsy findings during the first year following transplantation. ANALYTICAL APPROACH: We compared estimated glomerular filtration rate (eGFR), findings on for-cause and surveillance protocol biopsies, development of de novo donor-specific antibodies (DSAs), and patient and allograft outcomes during the first year following transplantation between recipients of HCV+ and HCV- kidneys. We used linear regression to estimate the independent association between allograft function and HCV viremic status of the kidney donor. RESULTS: The mean age of recipients was 52 ± 11 (SD) years, 43% were female, 19% and 80% of recipients were White and Black, respectively. Baseline characteristics were similar between the HCV+ and HCV- groups. There were no statistically significant differences between the HCV+ and HCV- groups in delayed graft function rates (12% vs 8%, respectively); eGFRs at 3, 6, 9, and 12 months post-transplantation; proportions of patients with cellular rejection (6% vs 7%, respectively); and proportions with antibody-mediated rejection (7% vs 10%, respectively) or de novo DSAs (31% vs 20%, respectively). HCV viremic status was not associated with eGFR at 3, 6, 9, or 12 months. LIMITATIONS: Generalizability from a single-center study and small sample size was limited. CONCLUSIONS: Recipients of kidneys from donors infected with HCV had similar kidney allograft function and probability of rejection in the first year after transplantation compared to those who received kidneys from donors without HCV infection.
RATIONALE & OBJECTIVE: Transplant centers in the United States are increasingly willing to transplant kidneys from hepatitis C virus (HCV)-infected (HCV+) donors into HCV- recipients. We studied the association between donor HCV infection status and kidney allograft function and posttransplantation allograft biopsy findings. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: We examined 65 HCV- recipients who received a kidney from a HCV+ donor and 59 HCV- recipients who received a kidney from a HCV- donor during 2018 at a single transplant center. EXPOSURE: Predictor(s) of donor infection with HCV. OUTCOMES: Kidney allograft function and allograft biopsy findings during the first year following transplantation. ANALYTICAL APPROACH: We compared estimated glomerular filtration rate (eGFR), findings on for-cause and surveillance protocol biopsies, development of de novo donor-specific antibodies (DSAs), and patient and allograft outcomes during the first year following transplantation between recipients of HCV+ and HCV- kidneys. We used linear regression to estimate the independent association between allograft function and HCV viremic status of the kidney donor. RESULTS: The mean age of recipients was 52 ± 11 (SD) years, 43% were female, 19% and 80% of recipients were White and Black, respectively. Baseline characteristics were similar between the HCV+ and HCV- groups. There were no statistically significant differences between the HCV+ and HCV- groups in delayed graft function rates (12% vs 8%, respectively); eGFRs at 3, 6, 9, and 12 months post-transplantation; proportions of patients with cellular rejection (6% vs 7%, respectively); and proportions with antibody-mediated rejection (7% vs 10%, respectively) or de novo DSAs (31% vs 20%, respectively). HCV viremic status was not associated with eGFR at 3, 6, 9, or 12 months. LIMITATIONS: Generalizability from a single-center study and small sample size was limited. CONCLUSIONS: Recipients of kidneys from donors infected with HCV had similar kidney allograft function and probability of rejection in the first year after transplantation compared to those who received kidneys from donors without HCV infection.
Authors: Miklos Z Molnar; Vishnu S Potluri; Douglas E Schaubel; Meghan E Sise; Beatrice P Concepcion; Rachel C Forbes; Emily Blumberg; Roy D Bloom; David Shaffer; Raymond T Chung; Ian A Strohbehn; Nahel Elias; Ambreen Azhar; Mital Shah; Deirdre Sawinski; Laura A Binari; Manish Talwar; Vasanthi Balaraman; Anshul Bhalla; James D Eason; Behdad Besharatian; Jennifer Trofe-Clark; David S Goldberg; Peter P Reese Journal: Am J Transplant Date: 2021-10-06 Impact factor: 8.086
Authors: M Elle Saine; Erin M Schnellinger; Michel Liu; Joshua M Diamond; Maria M Crespo; Stacey Prenner; Vishnu Potluri; Christian Bermudez; Heather Mentch; Michaella Moore; Behdad Besharatian; David S Goldberg; Frances K Barg; Peter P Reese Journal: Transplant Direct Date: 2022-07-19
Authors: Jiten P Kothadia; Anshul Bhalla; Miklos Z Molnar; Rahul Mohan; Vasanthi Balaraman; Manish Talwar; Ryan Helmick; Corey Eymard; Ian Clark; Richa Jain; Thomas W Faust; Jason M Vanatta; James D Eason; Satheesh P Nair Journal: Transplant Direct Date: 2022-05-26
Authors: Beatrice P Concepcion; Laura A Binari; Heidi Schaefer; Scott Rega; Irene Feurer; Saed Shawar; Ruchi Naik; Laura Hickman; Jasmine Walker; Meghan Kapp; Kelly A Birdwell; Anthony Langone; J Harold Helderman; Bonnie Ann Sarrell; Guneet Kochar; Bernard Dubray; Kristin Smith; Heather O'Dell; April DeMers; Princess Shelton; Roman Perri; David Shaffer; Rachel C Forbes Journal: Transplant Direct Date: 2021-09-07
Authors: Ambreen Azhar; Makoto Tsujita; Manish Talwar; Vasanthi Balaraman; Anshul Bhalla; James D Eason; Simonne S Nouer; Keiichi Sumida; Adam Remport; Isaac E Hall; Randi Griffin; George Rofaiel; Miklos Z Molnar Journal: Ren Fail Date: 2022-12 Impact factor: 3.222