Elderly recipients of hepatitis C positive renal allografts can quickly develop liver disease.
Our institution explored using allografts from donors with Hepatitis C virus (HCV) for elderly renal transplantation (RT). Thirteen HCV- elderly recipients were transplanted with HCV+ allografts (eD+/R-) between January 2003 and April 2009. Ninety HCV- elderly recipients of HCV- allografts (eD-/R-), eight HCV+ recipients of HCV+ allografts (D+/R+) and thirteen HCV+ recipients of HCV- allografts (D-/R+) were also transplanted. Median follow-up was 1.5 (range 0.8-5) years. Seven eD+/R- developed a positive HCV viral load and six had elevated liver transaminases with evidence of hepatitis on biopsy. Overall, eD+/R- survival was 46% while the eD-/R- survival was 85% (P = 0.003). Seven eD+/R- died during follow-up. Causes included multi-organ failure and sepsis (n = 4), cancer (n = 1), failure-to-thrive (n = 1) and surgical complications (n = 1). One eD+/R- died from causes directly related to HCV infection. In conclusion, multiple eD+/R- quickly developed HCV-related liver disease and infections were a frequent cause of morbidity and mortality.
Department of Surgery, University of Virginia Health System, Charlottesville, Virginia 22908-0709, USA. trf7b@virginia.edu
Tanya R
TR
Flohr
Hugo
H
Bonatti
Tjasa
T
Hranjec
Doug S
DS
Keith
Peter I
PI
Lobo
Sean C
SC
Kumer
Timothy M
TM
Schmitt
Robert G
RG
Sawyer
Timothy L
TL
Pruett
John P
JP
Roberts
Kenneth L
KL
Brayman
D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000188:drug therapy / Q000401:mortality; D006085:Graft Survival; D006526:Hepatitis C / Q000401:mortality / Q000635:transmission*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011183:Postoperative Complications / Q000401:mortality / Q000821:virology*; D014019:Tissue Donors; D014184:Transplantation, Homologous; D055815:Young Adult
D007166:Immunosuppressive Agents