Abstract
Waitlist time for kidney transplantation is long but may be shortened with the utilization of hepatitis C positive allografts. We retrospectively reviewed the course of 36 hepatitis C positive patients awaiting kidney transplantation at 2 large centers within the same health system, with near-identical care delivery models with the exception of timing of hepatitis C treatment, to determine the impact of timing of hepatitis C treatment on access to transplant, waitlist time, and treatment efficacy and tolerability. The majority of patients had hepatitis C genotype 1a or 1b, and all received direct acting antiviral therapy with 100% treatment response. One patient underwent transplantation in the pretransplant treatment group. The 1-year transplantation rate was 12.5% vs 67.9% (P =.0013) in those treated posttransplantation. The median waitlist time in the posttransplant group was 122 (interquartile range [IQR] 21.5, 531.0) days, which was significantly shorter than the center’s regional and national wait time. Pathologic review revealed no difference in allograft quality. Overall treatment related adverse events were not different between the 2 groups. A strategy of posttransplant hepatitis C treatment increased access to transplant and reduced waitlist time. Delaying treatment until after transplant did not appear to adversely affect recipients’ kidney allograft or overall survival.
Original language | English (US) |
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Pages (from-to) | 2559-2565 |
Number of pages | 7 |
Journal | American Journal of Transplantation |
Volume | 18 |
Issue number | 10 |
DOIs | |
State | Published - Oct 2018 |
Keywords
- cirrhosis
- clinical research/practice
- complication
- donors and donation
- extended criteria
- infectious
- infectious disease
- kidney disease
- kidney transplantation/nephrology
- liver disease
ASJC Scopus subject areas
- Immunology and Allergy
- Transplantation
- Pharmacology (medical)