September 12, 2019
With more than 93,000 people waiting for a kidney transplant in the United States, patients and healthcare professionals are eager to locate healthy organs that have a strong chance of survival.
New research from Penn Medicine suggests that Hepatitis C-infected kidneys function just as well as uninfected kidneys in transplant patients throughout the first year following surgery.
With the emergence of new antitviral treatments in recent years, infected kidneys that were discarded in previous decades have become more viable for transplantation.
While HCV-infected kidneys have generally been used for patients already infected with the virus, they became more widely matched with uninfected patients beginning in 2018, when nearly 75% of patients who received these infected kidneys did not have Hepatitis C.
Researchers at Penn Medicine have published results from these cases after a year, finding promise in broader use of HCV-infected kidneys.
"These striking results provide additional evidence that the (Kidney Donor Profile Index) does not accurately assess the quality of kidneys from HCV-positive donors," said Peter Reese, a corresponding author of the study published in the Journal of the American Society of Nephrology.
"Rescaling the index to reflect these positive outcomes might lead clinicians to offer these kidneys to younger patients with longer life expectancy, when clinically appropriate, and could help expand access for the nearly 100,000 Americans awaiting a kidney transplant," Reese added.
Penn Medicine began testing these results in 2016, following up transplantation with antiviral therapy to gauge outcomes in patients without Hepatitis C.
A broader review of data and outcomes from the national transplant registry between 2015 and 2019 showed that these results were consistent across carefully matched sets of recipients.
In 2015, only 11 transplant center were using HCV-infected kidneys. That number increased to 39 by 2019, yet nearly 40% of HCV-infected kidneys donated between Jan. 2018 and March 2019 were discarded.
"While the discard rate of these organs has declined in recent years, our findings suggest there is still substantial opportunity to expand the use of HCV-infected organs," said Vishnu Potluri, the study's lead author. "Our results suggest we should make it a priority to maximize the use of good-quality HCV-infected organs."