DOI: 10.4103/ijkd.ijkd_25_26 ISSN: 2950-0761

Impact of Prior Hepatitis C Infection on Post-transplant Outcomes in Deceased Donor Kidney Recipients: A Real-world Retrospective Observational Study in the Era of Directly Acting Antivirals

K. Ganapathy Raja, Rakesh Sebastin, Manorajan Rajendran, S. Balamurugan, Rakesh Durai
Show PDF Cite

A
BSTRACT

Background:

Management of Hepatitis C virus (HCV)infection with Directly -acting antiviral drugs (DAAs) has drastically improved the chances of sustained virologic remission(SVR) and kidney transplantation in HCV-infected patients. However residual immunologic and hepatic sequelae may persist post-SVR, potentially influencing infection risk, rejection rates and graft survival. This study compares outcomes of HCV positive positive-transplant recipients with HCV negative-transplant recipients in the present era of DAAs.

Materials and Methods:

This retrospective cohort study included 102 deceased donor renal transplant recipients categorized into two groups: HCV-positive ( N = 40) patients and HCV-negative ( N = 62) patients. HCV-positive patients received DAAs and achieved SVR prior to transplant. Baseline characteristics, incidence and time of post-transplant complications, graft and patient survival, and causes of death were compared.

Results:

The HCV positive patients exhibited significantly higher incidences of pneumonia (35.0% vs. 9.7%, P = 0.002), tuberculosis (35.0% vs. 9.8%, P = 0.002), BK virus infection (15.0% vs. 1.6%, P = 0.014), acute rejection (47.5% vs. 21.0%, P = 0.005), chronic rejection (40.0% vs. 21.0%, P = 0.037), and liver dysfunction (27.5% vs. 6.7%, P = 0.004). Posttransplant urinary tract infection occurred significantly earlier in HCV positive patients (median 57 days vs. 95 days, P = 0.022). Importantly, death-censored survival was significantly shorter in HCV positive patients (mean 2289.2 days vs. 3547.5 days, P = 0.005). Infection was the leading cause of death in both groups, however higher in HCV positive patients (64.7% vs. 50.0%).

Conclusion:

The study showed poor outcomes of kidney transplantation in HCV positive recipients compared to HCV negative recipients despite the advances in its treatment.

More from our Archive