title: Are hepatitis C-positive allografts in simultaneous pancreas-kidney transplantation underutilized?
abstract: BACKGROUND
  A recent review reported that recipient HCV infection had no significant impact on acute rejection rates or patient survival in SPKT but the utilization of HCV(+) organs was negligible. Using the UNOS database, we sought to determine utilization rates for HCV(+) allografts in Simultaneous Pancreas-Kidney Transplantation (SPKT.
  
  
  METHODS
  The Organ Procurement and Transplant Network / United Network for Organ Sharing database was employed to obtain information regarding HCV(+) and HCV-negative (HCV(-)) SPKT recipients and the disposition of donor pancreata.
  
  
  RESULTS
  Between 2000 and January 2011, 702 of 25,904 donors (2.7%) were HCV(+) and met otherwise ideal criteria. We identified 16 patients who received HCV(+) organs for SPKT between 1995 and 2010. Four had kidney allograft losses secondary to chronic rejection. Six had pancreatic allograft losses: one due to pancreatitis, one to infection, one to chronic rejection, one to acute rejection and two to graft thrombosis. None of the sixteen patients were subsequently listed for liver transplantation. Meanwhile, 702 HCV(+) donors between the age of 14 and 40 with a BMI less than 30 were identified. During that time period, only 8 simultaneous pancreas-kidney transplants using HCV(+) donor organs occurred. Therefore, 694 HCV(+) pancreata were not utilized for SPKT in that time span.
  
  
  CONCLUSIONS
  16 patients have undergone SPKT with HCV(+) organs. Aggressive use of HCV(+) organs for SPKT could potentially lead to earlier transplantation for HCV(+) recipients and allow HCV(-) organs to be available more quickly for HCV(-) recipients additional research of this topic is warranted.
authors.affiliation: Division of Organ Transplantation, Albert Einstein Medical Center, Philadelphia, PA, U.S.A.
authors.forename: Jorge
authors.initials: J
authors.lastname: Ortiz
authors.forename: John
authors.initials: J
authors.lastname: Gunselman
authors.forename: Imran
authors.initials: I
authors.lastname: Javed
authors.forename: Stalin
authors.initials: S
authors.lastname: Campos
authors.forename: Kamran
authors.initials: K
authors.lastname: Khanmoradi
authors.forename: Radi
authors.initials: R
authors.lastname: Zaki
mesh_terms: D000293:Adolescent; D000328:Adult; D016208:Databases, Factual; D046148:Donor Selection / Q000379:methods* / Q000706:statistics & numerical data; D006084:Graft Rejection; D006085:Graft Survival; D006526:Hepatitis C; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods* / Q000401:mortality / Q000706:statistics & numerical data; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D016035:Pancreas Transplantation / Q000379:methods* / Q000401:mortality / Q000706:statistics & numerical data; D012042:Registries; D012189:Retrospective Studies; D014019:Tissue Donors / Q000706:statistics & numerical data / Q000600:supply & distribution; D014481:United States; D055815:Young Adult