Transplantation of kidneys from donors with hepatitis C antibody into recipients with pre-transplantation anti-HCV.
Hepatitis C virus (HCV) is transmitted by organ transplantation. Consequently, several organ procurement organizations have imposed a moratorium on use of organs from anti-HCV positive donors. Because of the inadequate supply of cadaver kidneys for transplantation, we adopted a policy to transplant kidneys from anti-HCV donors into anti-HCV positive recipients. During the period between March 1990 and December 1992, 24 anti-HCV positive dialysis patients received a kidney from anti-HCV positive donors (group I) and 40 anti-HCV positive patients received a kidney from anti-HCV negative donors (group II). We compared the prevalence of liver disease, anti-HCV, HCV RNA, graft and patient survival between groups. Pre-transplantation 17 of 24 (71%) patients in group I and 31 of 40 (79%) of patients in group II had serum HCV RNA. Post-transplantation follow-up was 26 +/- 8 months and 30 +/- 10 months in groups I and II, respectively. During follow-up, elevated ALT levels were present in 7 of 24 (29%) and 16 of 40 (40%) of patients in groups I and II, respectively (P > 0.05). Post-transplantation, all patients in both groups retained anti-HCV. The prevalence of HCV RNA post-transplantation was 22 of 23 (96%) patients in group I and 30 of 39 (77%) of patients in group II (P > 0.05). Graft and patient survival in group I (96% and 100%, respectively) were not significantly different from those in group II (93% and 98%, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
Morales
J M
JM
Department of Nephrology, Hospital 12 de Octubre, Madrid, Spain.
Campistol
J M
JM
Castellano
G
G
Andres
A
A
Colina
F
F
Fuertes
A
A
Ercilla
G
G
Bruguera
M
M
Andreu
J
J
Carretero
P
P
D000328:Adult; D005260:Female; D006085:Graft Survival; D016174:Hepacivirus / Q000276:immunology* / Q000302:isolation & purification; D006508:Hepatitis Antibodies / Q000276:immunology*; D006526:Hepatitis C / Q000276:immunology* / Q000601:surgery; D018937:Hepatitis C Antibodies; D006801:Humans; D007668:Kidney / Q000276:immunology; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012367:RNA, Viral / Q000032:analysis; D016019:Survival Analysis; D014019:Tissue Donors
D006508:Hepatitis Antibodies; D018937:Hepatitis C Antibodies; D012367:RNA, Viral