Influence of preexisting hepatitis C virus antibody positivity in simultaneous pancreas-kidney transplant recipients.
BACKGROUND
Preexisting hepatitis C virus (HCV) infection is implicated in diminished patient and graft survivals in renal transplant recipients. The impact of HCV infection on patient and graft survival in simultaneous pancreas-kidney transplantations is unclear. We evaluated the effect of preexisting HCV infection on patient and graft survival in simultaneous pancreas-kidney transplant (SPKT) recipients in the United States.


METHODS
Using the Organ Procurement and Transplant Network/United Network for Organ Sharing database as of March 2009, adult primary SPKT recipients transplanted from 1995 to 2008 were studied. We stratified recipients based on pretransplant HCV status as HCV positive (HCV+) or HCV negative (HCV-). Overall kidney graft, pancreas graft, and patient survival were compared.


RESULTS
A total of 10,809 adults received primary SPKT, of which 350 (3.2%) were HCV+. Less than 2% of the HCV+ recipients received organs from HCV+ donors. There were no significant differences in baseline donor and recipient characteristics between groups. Rates of acute kidney rejection at 1 year were similar: 22.9% for HCV+ and 23.0% for HCV- recipients (P=0.49). There was no difference in serum creatinine between groups up to 3 years. After controlling for confounding factors, HCV positivity was not associated with worsened overall kidney graft (hazard ratio [HR] 0.80, 95% confidence interval [CI] 0.61-1.03), pancreas graft (HR 0.80, 95% CI 0.63-1.00), or patient survival (HR 0.78, 95% CI 0.56-1.08).


CONCLUSIONS
Only 3.2% of SPKT recipients had preexisting HCV infection. Preexisting HCV infection had no significant impact on kidney graft, pancreas graft, or patient survival.
Miguel
Maria
M
Division of Nephrology, Kidney and Pancreas Transplant Program, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
Sampaio
Marcelo Santos
MS
Kuo
Hung-Tien
HT
Poommipanit
Neda
N
Martin
Paul
P
Bunnapradist
Suphamai
S
D000328:Adult; D002102:Cadaver; D002423:Cause of Death; D018450:Disease Progression; D005260:Female; D006085:Graft Survival; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000401:mortality / Q000502:physiology*; D014019:Tissue Donors / Q000706:statistics & numerical data; D014481:United States