Kidney transplantation from hepatitis C virus-positive donors into hepatitis C virus-positive recipients: a safe way to expand the donor pool?
BACKGROUND
Because the disparity between the number of patients waiting for kidney transplants and the number of available cadaveric renal allografts continues to increase, there is a clear need to review the inclusion criteria for cadaveric donors.


METHODS
From January 2001 to March 2004, 24 patients with end-stage renal disease and hepatitis C virus (HCV) seropositivity underwent a kidney transplantation. In 10 transplants in HCV-positive recipients, the donor was HCV-positive (D+/R+) and in 14 cases the donor (1 living donor) was HCV-negative (D-/R+).


RESULTS
Two of 3 HCV-RNA-negative recipients who received a HCV-RNA+ kidney became HCV-RNA+ in the posttransplantation period. There was a low rate of acute rejection (8.3%). One D+/R+ patient experienced an acute vascular rejection, which finally resulted in graft loss, due to the resurgence of severe infectious disease. The serum creatinine levels at 6 months posttransplantation were similar in both groups. Acute liver dysfunction was observed in 1 patient. There was no death in the entire series. Graft survival was 92% and 90% for D+/R+ and D-/R+, respectively.
Veroux
P
P
Department of Surgery, Transplantation and Advanced Technologies, Organ Transplant Unit, University Hospital, Catania, Italy.
Veroux
M
M
Puliatti
C
C
Cappello
D
D
Macarone
M
M
Gagliano
M
M
Fiamingo
P
P
Flamingo
P
P
Di Mare
M
M
Spataro
M
M
Ginevra
N
N
D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006526:Hepatitis C / Q000150:complications* / Q000635:transmission*; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D017093:Liver Failure / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D012449:Safety; D014019:Tissue Donors / Q000600:supply & distribution*; D019562:Viral Load; D014850:Waiting Lists
D012367:RNA, Viral