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Shorter Waitlist Times and Improved Graft Survivals Are Observed in Patients Who Accept Hepatitis C Virus+ Renal Allografts

Background There is a paucity of data regarding long-term renal graft survival in hepatitis C virus positive (HCV+) patients. We analyzed our institution’s experience with HCV+ renal transplantation and factors contributing to subsequent renal graft failure. Methods We analyzed 1,679 adult, deceased donor, single-organ renal transplants occurring between 2000 and 2012. Recipient and donor demographics, HCV serostatus, and graft outcome and function were evaluated. Results Of 1,679 patients, 195 HCV+ recipients (R+) received renal transplants from HCV+ donors (D+), in contrast to 1,418 HCV negative (HCV−) recipients (R−) who received grafts from HCV− donors (D−), and 66 R+ patients who received D− kidneys. Death-censored graft survival in the R+/D+ population was better than graft survival for R+/D− patients, despite R+/D+ patients having higher rates of hypertension and African Americans. Waitlist times for patients accepting HCV+ grafts was 318 days (for R+/D+ patients) versus 613 days (R−/D−) or 570 days (R+/D−). On multivariate analysis, waitlist times were independently predictive of graft failure. Conclusion R+/D+ patients spent less time on the transplant waitlist, which contributed to improved death censored graft survival when compared with R+/D− patients.