Analysis of the effects of donor and recipient hepatitis C infection on kidney transplant outcomes in the United States

作     者：Qing Yuan Shanjuan Hong Gregory Leya Eve Roth Georgios Tsoulfas WW Williams Joren C Madsen Nahel Elias 

作者机构：Department of UrologyChinese PLA General HospitalBeijing 100853China Transplant Center and Center for Transplantation SciencesMassachusetts General HospitalBostonMA 02114United States Department of SurgeryAristototle University of ThessalonikiThessaloniki 54124Greece Department of MedicineMassachusetts General HospitalBostonMA 02114United States Division of Cardiac SurgeryMassachusetts General HospitalBostonMA 02114United States Division of Transplant SurgeryMassachusetts General HospitalBostonMA 02114United States 

出 版 物：《World Journal of Transplantation》 (世界移植杂志)

年 卷 期：2023年第13卷第2期

页      面：44-57页

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100401[医学-流行病与卫生统计学] 10[医学] 

主　　题：Hepatitis C virus Kidney transplantation Direct-acting antiviral therapy Propensity score matching 

摘      要：BACKGROUND As Hepatitis C virus infection(HCV+)rates in kidney donors and transplant recipients rise,direct-acting antivirals(DAA)may affect *** To analyze the effects of HCV+in donors,recipients,or both,on deceased-donor(DD)kidney transplantation(KT)outcomes,and the impact of DAAs on those *** The Organ Procurement and Transplantation Network data of adult first solitary DD-KT recipients 1994-2019 were allocated into four groups by donor and recipient HCV+*** performed patient survival(PS)and death-censored graft survival(DCGS)pairwise comparisons after propensity score matching to assess the effects of HCV+in donors and/or recipients,stratifying our study by DAA era to evaluate potential effect *** Pre-DAA,for HCV+recipients,receiving an HCV+kidney was associated with 1.28-fold higher mortality(HR 1.151.281.42)and 1.22-fold higher death-censored graft failure(HR 1.***.221.39)compared to receiving an HCV-kidney and the absolute risk difference was 3.3%(95%CI:1.8%-4.7%)for PS and 3.1%(95%CI:1.2%-5%)for DCGS at 3 *** HCV dual-infection(donor plus recipient)group had worse PS(0.56-fold)and DCGS(0.71-fold)than the *** HCV+derived worse post-transplant outcomes than recipient HCV+(PS 0.36-fold,DCGS 0.34-fold).In the DAA era,the risk associated with HCV+in donors and/or recipients was no longer statistically significant,except for impaired PS in the dual-infected vs dual-uninfected(0.43-fold).CONCLUSION Prior to DAA introduction,donor HCV+negatively influenced kidney transplant outcomes in all recipients,while recipient infection only relatively impaired outcomes for uninfected *** adverse effects disappeared with the introduction of DAA.