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Transplanting Hepatitis C-Infected Kidneys to Hepatitis C-Negative Recipients: A New Standard of Care?

In current practice, hepatitis C-infected kidneys are exclusively transplanted to patients already infected with the disease. However, the number of available infected kidneys greatly exceeds the infected population. This has resulted in approximately 1,000 or more hepatitis C-infected kidneys to be discarded annually.

A recent observational study by physicians at the University of Tennessee Science Center and the James D. Eason Transplant Institute at Methodist University Hospital, Tennessee, USA, has revealed that transplantation of kidneys from hepatitis C-infected donors to uninfected recipients is safe and can be applied as a standard of care. The study began in 2018, in which >80 uninfected recipients received hepatitis C-infected kidneys; however, only 53 patients are cited because the remainder are too soon after transplantation to fully evaluate. After being made aware that they would receive infected kidneys, all patients consented to the surgery in three separate stages. Successful transplantation of the kidney was followed by 12 weeks of antiviral therapy. A follow up showed no signs of hepatitis C in these patients and all kidneys were considered ‘cured’. Additionally, no mortalities occurred during the study; however, unexpected complications did arise. Furthermore, the common and generally treatable, post transplantation BK virus was recorded in a number of patients.

Prof Molnar, associate professor of Medicine at University of Tennessee Science Center  and transplant nephrologist at the James D. Eason Transplant Institute, noted that the study results are positive for patients that require a kidney transplant and that “if you are willing to accept these kidneys, the waiting time can go down by two years.” Prof Molnar states that the study indicates that transplantation of hepatitis C-infected kidneys to hepatitis C-negative recipients has the potential to become the standard of care in the USA. Ultimately, this practice could increase the number of kidneys available for transplantation and reduce the waiting time for patients.