# Use of Hepatitis C Virus Antibody-Positive Donors in Kidney Transplantation

## TL;DR

This paper shows that using kidneys from donors with hepatitis C antibodies is safe and can help increase the number of available organs for transplantation.

## Contribution

The study provides empirical evidence supporting the safety of using HCV antibody-positive donors in kidney transplantation.

## Key findings

- Five transplants using HCV antibody-positive donors showed no HCV viremia in recipients.
- Seroconversion occurred in half of the patients but did not lead to viremia or complications.
- Recipient outcomes, including kidney function and rejection rates, were favorable.

## Abstract

Background

The use of kidney donors with hepatitis C virus (HCV) has been arising as a possibility to increase the donor pool. It encompasses both the use of donors with positive and negative viremia, particularly since the advent of direct antiviral agents that produce sustained virologic response.

Methodology

We conducted a retrospective observational study to describe the experience of our transplantation center in the use of HCV antibody-positive (HCV-Ab+) kidneys.

Results

We performed five transplants with HCV-Ab+ donors. The median age of kidney recipients was 63 (interquartile range (IQR) = 54-71) years, and 60% (n = 3) were males. Two recipients received a second transplant. The median dialysis vintage was 1,414 (IQR = 1,103-2,806) days. The induction immunosuppression protocol was basiliximab in most patients (60%, n = 3), and all received maintenance immunosuppression with tacrolimus, mycophenolate mofetil, and prednisolone. One of the recipients had a personal history of cured HCV infection. Seroconversion occurred in half of the remaining patients, which was sustained during the follow-up. None of the patients developed HCV viremia. At the end of follow-up, mean creatinine and proteinuria were 1.45 ± 1.12 mg/dL and 0.099 ± 0.045 g/g, respectively. We did not observe any rejection episodes, need for dialysis, or recipient’s death.

Conclusions

Our work aligns with the current literature that advocates that the use of these donors is safe and cost-effective and can be an effective strategy for expanding the donor pool and augmenting the transplantation volume. Seroconversion is a known risk whose mechanisms are not entirely understood, although it does not appear to be related to a higher transmission risk.