Journal article
Kidney transplant from HCV viremic donors to HCV-negative recipients and risk for de novo donor specific antibodies and acute rejection
CLINICAL TRANSPLANTATION, v 37(2)
Feb 2023
PMID: 36580971
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BackgroundKidney transplantation from HCV-viremic donors into uninfected recipients is associated with excellent short-term outcomes. However, concerns regarding an increased risk for the development of de novo donor specific antibodies (DSA) and acute rejection have been raised in single center reports. MethodsA retrospective study of HCV-negative kidney-only transplant recipients between 2018 and 2020. Patients were grouped based on the donor HCV status into group 1; HCV-viremic donors, and group 2; HCV-negative donors. Inverse probability of treatment weighting (IPTW), with weights derived from the propensity score, were used to estimate the effect of donors' HCV-viremia on the recipients. The primary objective was to compare the 1-year incidence of de novo DSA. Secondary outcomes included group comparison of the incidence of biopsy proven acute rejection (BPAR), 1-year patient and allograft survival, and 1-year renal allograft function. ResultsA total of 71 patients were included in the HCV NAT+ group, and 440 in the HCV- negative group. One-year incidence of de novo DSA was higher in the HCV NAT+ group in the IPTW weighted analysis (19% vs. 9%, p = .02). In the unweighted analysis, BPAR occurred in 7% of recipients in the HCV NAT+ group, compared to 3% in the control group (p = .06). However, due to the low event rate in the in the IPTW weighted groups, a statistical significance test could not be performed. Average estimated GFR was higher in the HCV-viremic group at 3 months (61 vs. 53 ml/min/1.73 m(2) p = .002), but comparable at 6 (59 vs. 56 ml/min/1.73 m(2), p = .31) and 12 months (60 vs. 55 ml/min/1.73 m(2), p = .07). Patient and allograft survival were comparable between the two groups. ConclusionKidney transplant from HCV-viremic donors was associated with an increased risk for the development of post-transplant de novo DSA in the first year after transplantation, but no difference in patient and graft survival.
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Details
- Title
- Kidney transplant from HCV viremic donors to HCV-negative recipients and risk for de novo donor specific antibodies and acute rejection
- Publication Details
- CLINICAL TRANSPLANTATION, v 37(2)
- Publisher
- WILEY; HOBOKEN
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Drexel University
- Web of Science ID
- WOS:000910177100001
- Scopus ID
- 2-s2.0-85146272941
- Other Identifier
- 991021861185904721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Surgery
- Transplantation