Clinical outcomes of hepatitis C treatment before and after kidney transplantation and its impact on time to transplant: A multicenter study

D. M. Chascsa, O. Y. Mousa, Surakit Pungpapong, N. Zhang, A. Chervenak, S. Nidamanuri, E. Rodriguez, D. Franco, K. Ryland, A. P. Keaveny, J. L. Huskey, M. Smith, Kunam Sudhakar Reddy, C. B. Taner, Hugo E Vargas, B. A. Aqel

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Waitlist time for kidney transplantation is long but may be shortened with the utilization of hepatitis C positive allografts. We retrospectively reviewed the course of 36 hepatitis C positive patients awaiting kidney transplantation at 2 large centers within the same health system, with near-identical care delivery models with the exception of timing of hepatitis C treatment, to determine the impact of timing of hepatitis C treatment on access to transplant, waitlist time, and treatment efficacy and tolerability. The majority of patients had hepatitis C genotype 1a or 1b, and all received direct acting antiviral therapy with 100% treatment response. One patient underwent transplantation in the pretransplant treatment group. The 1-year transplantation rate was 12.5% vs 67.9% (P =.0013) in those treated posttransplantation. The median waitlist time in the posttransplant group was 122 (interquartile range [IQR] 21.5, 531.0) days, which was significantly shorter than the center’s regional and national wait time. Pathologic review revealed no difference in allograft quality. Overall treatment related adverse events were not different between the 2 groups. A strategy of posttransplant hepatitis C treatment increased access to transplant and reduced waitlist time. Delaying treatment until after transplant did not appear to adversely affect recipients’ kidney allograft or overall survival.

Original languageEnglish (US)
Pages (from-to)2559-2565
Number of pages7
JournalAmerican Journal of Transplantation
Volume18
Issue number10
DOIs
StatePublished - Oct 1 2018

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Keywords

  • cirrhosis
  • clinical research/practice
  • complication
  • donors and donation
  • extended criteria
  • infectious
  • infectious disease
  • kidney disease
  • kidney transplantation/nephrology
  • liver disease

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

Cite this

Chascsa, D. M., Mousa, O. Y., Pungpapong, S., Zhang, N., Chervenak, A., Nidamanuri, S., Rodriguez, E., Franco, D., Ryland, K., Keaveny, A. P., Huskey, J. L., Smith, M., Reddy, K. S., Taner, C. B., Vargas, H. E., & Aqel, B. A. (2018). Clinical outcomes of hepatitis C treatment before and after kidney transplantation and its impact on time to transplant: A multicenter study. American Journal of Transplantation, 18(10), 2559-2565. https://doi.org/10.1111/ajt.14931